Utilization Management Coordinator II

Role Overview

• Provide support to the Medical Management department
• Ensure the timeliness of outpatient or inpatient referral/authorization processing per state and federal guidelines
• Perform troubleshooting when problem situations arise
• Take independent action to resolve complex issues

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

Benefits

• 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