Hybrid Utilization Management Coordinator II

AltaMed Health Services; Montebello (CA); Hybrid; USD 37,084 - 46,356; Full time

Benefits offered by this job

Medical, dental, vision

403(b) Retirement plan

Paid Time Off & Holidays

CME days

Tuition reimbursement

Employee discounts

Referral bonus

Tail coverage

Job summary

AltaMed Health Services in Montebello, CA is seeking a Coordinator II, Utilization Management to support the Medical Management department in timely referral/authorization processing per state and federal guidelines. The role involves troubleshooting and taking independent action to resolve complex issues.

Minimum requirements include a High School Diploma, 2+ years in medical billing (Medi-Cal/ CCS knowledge a plus), and experience in utilization management and pre-authorizations.

Qualifications

• High School Diploma or equivalent required.
• MA or Medical Billing Certificate preferred.
• Minimum 2 years of experience working in a medical billing environment (IPA or HMO preferred).
• Experience with pre-authorizations and reimbursement regulations (Medi-Cal, CCS, etc.).
• Experience in utilization management and processing authorization referrals.

Responsibilities

• Support Medical Management to ensure timely referral/authorization processing per guidelines.
• Troubleshoot and resolve complex issues in the authorization workflow.
• Collaborate with teams to maintain regulatory compliance and efficiency.

Skills

Utilization management

Medical billing

Pre-authorizations

Education

High School Diploma

Medical Billing Certificate

Job description

AltaMed Health Services in Montebello, CA is seeking a Coordinator II, Utilization Management to support the Medical Management department in timely referral/authorization processing per state and federal guidelines. The role involves troubleshooting and taking independent action to resolve complex issues.

Minimum requirements include a High School Diploma, 2+ years in medical billing (Medi-Cal/ CCS knowledge a plus), and experience in utilization management and pre-authorizations.