Utilization Management Coordinator I — Drive Care Access

altamed; Commerce (CA); On-site; USD 37,000 - 46,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

403(b) retirement

Flexible Spending Accounts

Paid Time Off

CME days

Malpractice tail coverage

Tuition reimbursement

Employee discounts

Pet care insurance

Job summary

AltaMed Health Services Corp. is seeking a medical billing/authorization specialist to support the Senior Care Services/PACE department. You will ensure timely processing of referrals and authorizations in line with state and federal guidelines.

The role requires 1+ year in a medical billing setting (IPA/HMO preferred), familiarity with Medi-Cal/CCS programs, and experience in a clinic call center. Strong troubleshooting and coordination with leadership are essential.

Qualifications

• Minimum 1 year of experience in a medical billing environment (IPA or HMO preferred) with pre-authorizations and reimbursement regulations with Medi-Cal, CCS, and other government programs.
• Prior experience working in a clinic/health care specialty call center.
• Prefer experience in utilization management, processing authorization referrals.

Responsibilities

• Support the Senior Care Services/PACE department to ensure timeliness of outpatient or inpatient referral/authorization processing per state and federal guidelines.
• Perform troubleshooting when problem situations arise.
• Coordinate with leadership to resolve issues and streamline processes.

Skills

Medical billing experience

Pre-authorizations

Clinic call center

Utilization management

Authorization referrals

Education

High School Diploma or equivalent

Medical Billing Certificate

Job description

AltaMed Health Services Corp. is seeking a medical billing/authorization specialist to support the Senior Care Services/PACE department. You will ensure timely processing of referrals and authorizations in line with state and federal guidelines.

The role requires 1+ year in a medical billing setting (IPA/HMO preferred), familiarity with Medi-Cal/CCS programs, and experience in a clinic call center. Strong troubleshooting and coordination with leadership are essential.