Utilization Management Coordinator II

Santa Barbara Cottage Hospital; United States; Remote; USD 60,000 - 80,000; Full time

Job summary

A leading healthcare provider is seeking a Coordinator II for Utilization Management. This role involves managing outpatient and inpatient referrals, ensuring compliance with state and federal guidelines. The ideal candidate will have experience in medical billing and utilization management, along with strong problem-solving skills. Join us to make a meaningful difference in community health.

Benefits

Medical, Dental, and Vision insurance

403(b) Retirement savings plans with employer matching

Flexible Spending Accounts

Commuter Flexible Spending

Opportunities for career advancement and development

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

Qualifications

• At least 2 years of experience in a medical billing environment.
• Knowledge of pre-authorizations and reimbursement regulations.

Responsibilities

• Support Medical Management department with referral/authorization processing.
• Troubleshoot issues and resolve complex problems.

Skills

Leadership

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

The Coordinator II, of Utilization Management, is responsible for supporting the Medical Management department to ensure timely outpatient or inpatient referral/authorization processing according to state and federal guidelines. This role involves troubleshooting issues and taking independent action to resolve complex problems.

Minimum Requirements

• High School Diploma or equivalent required.
• MA or Medical Billing Certificate preferred.
• At least 2 years of experience in a medical billing environment (IPA or HMO preferred), with knowledge of pre-authorizations and reimbursement regulations related to Medi-Cal, CCS, and other government programs.
• Prior experience in utilization management processing authorization referrals is required.
• Leadership experience is a plus.

Compensation

$26.92 - $33.65 hourly

Compensation Disclaimer

Actual salary offers depend on various factors including budget, experience, skills, education, licensure, certifications, and other considerations. The range is subject to change. AltaMed is committed to providing a fair and competitive compensation package that reflects the candidate's value and the strategic importance of the role. Discretionary bonuses or incentives may also apply.

Benefits & Career Development

• Medical, Dental, and Vision insurance
• 403(b) Retirement savings plans with employer matching
• Flexible Spending Accounts
• Commuter Flexible Spending
• Opportunities for career advancement and development
• 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

AltaMed Health Services Corp. considers qualified applicants with criminal histories in accordance with the California Fair Chance Act and Los Angeles Fair Chance Ordinance. Applicants are not required to disclose criminal history until a conditional offer is made. After the background check, if concerns arise related to a conviction, applicants will have the opportunity to explain, provide mitigating evidence, or contest the report.