Utilization Management Coordinator II

altamed; Montebello (CA); On-site; USD 37,084 - 46,356; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

401(k) Retirement Plan

Job summary

AltaMed is seeking a Coordinator II of Utilization Management to support the Medical Management team and ensure timely outpatient or inpatient referral/authorization processing in line with state and federal guidelines.

The role requires 2+ years in medical billing, experience with pre-authorizations and government programs, and preferred lead experience. AltaMed offers comprehensive benefits and career development opportunities.

Qualifications

• High School Diploma or equivalent required.
• MA or Medical Billing Certificate preferred.
• At least 2 years in medical billing with pre-authorizations and government programs knowledge.
• Experience in utilization management and processing authorization referrals required.
• Lead position experience preferred.

Responsibilities

• This Coordinator II provides support to the Medical Management department to ensure timely processing of referrals and authorizations per state and federal guidelines.
• They troubleshoot and take independent action to resolve complex issues related to authorization processing.

Skills

Medical billing

Authorization processing

Utilization management

Problem solving

Lead experience

Education

High School Diploma

Medical Billing Certificate

Job description

Grow Healthy

If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn’t just welcomed – it’s nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don’t just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it’s a calling that drives us forward every day.

Job Overview

This Coordinator II of Utilization Management is responsible for providing support to the Medical Management department to ensure the timeliness of outpatient or inpatient referral/authorization processing per state and federal guidelines. This position performs troubleshooting when problem situations arise and takes independent action to resolve complex issues.

Minimum Requirements

• 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), with pre-authorizations and reimbursement regulations about Medi-Cal, CCS, and other government programs required.
• Prior experience in utilization management, processing authorization referrals is also required.
• Prefer prior Lead position experience.

Compensation

$26.92 - $33.65 hourly

Compensation Disclaimer

Actual salary offers are considered by various factors, including budget, experience, skills, education, licensure and certifications, and other business considerations. The range is subject to change. AltaMed is committed to ensuring a fair and competitive compensation package that reflects the candidate's value and the role's strategic importance within the organization. This role may also qualify for discretionary bonuses or incentives.

Benefits & Career Development

• Medical, Dental and Vision insurance
• 403(b) Retirement savings plans with employer matching contributions
• Flexible Spending Accounts
• Commuter Flexible Spending
• Career Advancement & Development opportunities
• Paid Time Off & Holidays
• Paid CME Days
• Malpractice insurance and tail coverage
• Tuition Reimbursement Program
• Corporate Employee Discounts
• Employee Referral Bonus Program
• Pet Care Insurance

Job Advertisement & Application Compliance Statement

AltaMed Health Services Corp. will consider qualified applicants with criminal history pursuant to the California Fair Chance Act and City of Los Angeles Fair Chance Ordinance for Employers. You do not need to disclose your criminal history or participate in a background check until a conditional job offer is made to you. After making a conditional offer and running a background check, if AltaMed Health Service Corp. is concerned about a conviction directly related to the job, you will be given a chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report.