Remote Integrated Care Coordinator (Bilingual)

Inland-Empire-Health-Plan-; Rancho Cucamonga (CA); Hybrid; USD 33,000 - 43,000; Part time

Job summary

Inland Empire Health Plan (IEHP) is seeking a Coordinator - Integrated Transitional Care in California for a short-term assignment. The role emphasizes timely processing of authorizations, eligibility checks, and coordinating non-clinical tasks within the ITC team.

The position requires knowledge of ICD-10 and CPT coding, along with strong data-entry and communication skills. Bilingual English/Spanish ability is required and a language proficiency assessment will be conducted.

Qualifications

• Minimum of two (2) years of experience as a data entry specialist.
• Data entry specialist experience preferably in an HMO or Managed Care setting.
• Utilization Management experience preferred.
• High School Diploma or GED required.
• Applicable to bilingual job code only - Bilingual (English/Spanish) - written and verbal skills required.

Responsibilities

• Monitor the Right Fax server, EDI Interface, and medical management system intake to ensure face sheets are processed timely.
• Ensure face sheets reflect current Member demographic information and are complete and accurate.
• Review daily census to identify duplicates and non-required admissions.
• Cover call queues and assist ITC nurses with authorizations and reviews.
• Attach reviews and orders for ITC nurse review in the medical management system.
• Review and approve service requests within ITC Coordinator scope.
• Obtain Member discharge dates via calls or EMR/memo submissions.
• Meet productivity and accuracy standards for inpatient authorizations and discharges.
• Assist with referrals by contacting providers to request additional information.
• Set up hospital follow-up appointments and document calls.
• Ensure Members receive Home Health or DME as ordered and document communications.
• Coordinate disenrollment and transportation as needed.
• Represent IEHP professionally in Utilization Management calls.
• Communicate with providers/facilities alongside ITC Nurse regarding authorizations.
• Assist ITC Nurse in care management coordination for Members.
• Identify HEDIS gaps and perform outreach with Members.
• Ensure documentation complies with regulatory and accreditation standards.
• Support Management or Inpatient Clinical Team as requested.
• Attend meetings and promote a collaborative CM team environment.

Skills

Data entry

Customer service

Bilingual (English/Spanish)

Microsoft Office

ICD-10 knowledge

CPT codes

Driver's license

Education

High School Diploma or GED

Tools

Word processing

Database

Spreadsheets

Job description

Inland Empire Health Plan (IEHP) is seeking a Coordinator - Integrated Transitional Care in California for a short-term assignment. The role emphasizes timely processing of authorizations, eligibility checks, and coordinating non-clinical tasks within the ITC team.

The position requires knowledge of ICD-10 and CPT coding, along with strong data-entry and communication skills. Bilingual English/Spanish ability is required and a language proficiency assessment will be conducted.