Utilization Management Coordinator I (PACE)

Work set-up: 
Full Remote
Contract: 
Work from: 

Offer summary

Qualifications:

High School Diploma or equivalent is required., Medical Assistant or Medical Billing Certificate is preferred., At least 1 year of experience in a medical billing environment, especially with pre-authorizations and reimbursement regulations for Medi-Cal, CCS, or other government programs., Experience working in a healthcare call center or utilization management processing authorization referrals..

Key responsibilities:

  • Support the Senior Care Services/PACE department in processing outpatient and inpatient referrals and authorizations.
  • Troubleshoot issues that arise during referral and authorization processes.
  • Coordinate with leadership to ensure compliance with state and federal guidelines.
  • Assist in ensuring timely processing of referrals and authorizations.

AltaMed Health Services logo
AltaMed Health Services Health, Sport, Wellness & Fitness Large http://www.AltaMed.org/
1001 - 5000 Employees
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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 position is responsible for providing support to the Senior Care Services/PACE department to ensure timeliness of outpatient or inpatient referral/authorization processing per state and federal guidelines. This position performs trouble-shooting when problems situations arise and coordinates with leadership.

Minimum Requirements

1. High School Diploma or equivalent required.

2. MA or Medical Billing Certificate preferred.

3. Minimum 1 year of experience working in a medical billing environment (IPA or HMO preferred), with pre-authorizations and reimbursement regulations pertaining to Medi-Cal, CCS and other government programs required.

4. Prior experience working in a clinic/health care specialty call center.

5. Prefer experience in utilization management processing authorization referrals.

Compensation

$25.00 - $30.00 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.

Required profile

Experience

Industry :
Health, Sport, Wellness & Fitness
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Communication
  • Problem Solving

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