UM Coordinator Needed w/Health Care Background
Well known company has a need for Utilization Management Coordinator.
**Bilingual Spanish is a plus!
Duties: The UM Coordinator supports the UM Specialist by handling all administrative and technical functions of the authorization process including intake, logging, tracking and status follow-up. Collects information required by clinical staff to render decisions, assists the Manager and Director of the Utilization Management department in meeting regulatory time lines by maintaining an accurate database inventory of referral authorizations, retrospective reviews, concurrent reviews and grievance/appeal requests, and prepares UM Activity and Weekly Compliance Reports. In addition, the position performs data entry and processing of referrals/authorizations in the system, authorizes request consistent with auto criteria, maintains confidentiality when communicating member information, and assists with the communication of determinations by preparing template letters for members/ providers, with other duties as assigned.
EDUCATION: High School Diploma or equivalent, Associate or Bachelor's degree preferred. Medical Terminology, prefers CPT/ ICD.9 coding SKILLS Must have held title of UM Coordinator or equivalent. At least two years of experience in Medi-Cal managed care authorization process; knowledge of medical terminology and ICD-9 and CPT codes; strong verbal and written communication skills; proficiency with Microsoft Word, Excel, and Access; and excellent organizational, interpersonal and time management skills. Must be detail-oriented and an enthusiastic team player. Knowledge of MHC and/or CSIIM computer systems a plus.
Preferred knowledge of MHC and CSIIM computer system.
To apply for this great position as a UM Coordinator today! Please forward resume to Azuri Ross for immediate consideration. Call the Downtown Los Angeles Act-1 office and ask for Azuri Ross.
We are an equal employment opportunity employer and will consider all qualified candidates without regard to disability or protected veteran status.