Utilization Management Outpatient Coordinator (Hybrid - Temporary)

Inland Empire Health Plans; Rancho Cucamonga (CA); On-site; USD 80,000 - 100,000; Full time

Job summary

Inland Empire Health Plans seeks an Outpatient UM Coordinator for a temporary six-month role to manage authorization requests and eligibility verification. Ideal candidates should have at least three years of relevant experience, a strong understanding of medical coding, and a commitment to delivering exceptional customer service.

Qualifications

• Minimum of three years experience as a data entry specialist or coordinator in Managed Care.
• Requires knowledge of ICD-9/10 and CPT codes.

Responsibilities

• Timely processing of authorization requests and verifying eligibility.
• Ensure high level of customer service during provider call responses.

Skills

Customer Service

ICD-9/10 knowledge

CPT Coding

Data Entry

Multitasking

Education

High school diploma or GED

Associate's degree or Bachelor's degree

Medical Assistant certificate

Tools

Computer applications (word processing, database, spreadsheets)

Job description

This position is a temporary role facilitated through one of our contracted agencies and is not a direct employment opportunity with IEHP. The contracted agency offers an assignment length of up to six months, during which the candidate will provide support for IEHP.

What you can expect!

Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to anauthentic experience!

Under the general direction of the UM Outpatient Manager and Supervisor, the Outpatient UM Coordinator, is a high paced position that requires timely processing of authorization requests, verifying eligibility and obtaining additional information as requested by Medical Management or Utilization Management Nurses. This position requires that one be organized, ability to multitask with a working knowledge of ICD.9/10, CPT Coding and Medical Terminology. The Outpatient UM Coordinator will also ensure that provider calls are responded to in an accurate and timely manner while always maintaining highest level of customer service.

Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Education & Requirements

• Minimum of three (3) years of experience as a data entry specialist or coordinator

  • Experience as a data entry specialist or coordinator preferably in an HMO or Managed Care setting

• High school diploma or GED required

  • Associate's degree or Bachelor's degree from an accreditedinstitution preferred

  • Medical Assistant certificate preferred

Key Qualifications

• Requires knowledge of ICD-9/10 and CPT codes
• Managed Care or physician office experience a must
• Skilled in computer applications, including word processing, database, and spreadsheets
• Good customer service skills
• While performing the duties of this job, team member is occasionally required to stand; walk; sit; use hands to finger, handle or feel objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; talk or hear; and use taste or smell
• The team member must occasionally lift or move up to 25 pounds
• Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus

Start your journey towards a thriving future with IEHP and apply TODAY!