Outpatient Referral Coordinator

4 weeks ago

Rancho Cucamonga, United States HealthCare Support Full time
Job DescriptionJob Description
HIRING: Outpatient Referral Coordinator - HYBRID, 2-3 days in office at Rancho Cucamonga, CA 91730

HealthCare Support is actively seeking Outpatient Referral Coordinator to fill an opening with a largest not-for-profit Medi-Cal and Medicare Health Plan in Rancho Cucamonga, CA 91730

Daily Responsibilities for Outpatient Referral Coordinator:
  • 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, in addition to collaboration with, inter-departments to ensure member needs are met while simultaneously building strong peer relationships.
    • 1. Responsible for monitoring the Right Fax Server. Ensuring all referrals are processed in a timely manner and ensuring compliance with appropriate turnaround timeframes.
      2. Responsible for checking the referral form for completeness, obtaining missing demographic information as needed, and initial attempts at coding any uncoded referrals.
      3. Responsible for meeting accuracy standards for appropriate authorizations of referrals at the UM Coordinator level.
      4. Responsible for representing the Inland Empire Health Plan in a friendly and professional manner while answering the calls for the Utilization Management Department.
      5. Communicate with providers in consultation with the Utilization Management Nurse, regarding authorizations, modifications, denials, and other matters pertinent to processing authorization requests or other UM related correspondence.
      6. Assist Management or Utilization Management Nurses as requested.

Required Qualifications for Outpatient Referral Coordinator:
  • High school diploma or GED (Associates or Bachelors preferred)
  • 3+ years of healthcare data entry experience
  • 2+ years of experience working with authorizations and referrals within a MCO or physician office setting
  • Experience working with ICD and CPT codes, as well as medical terminology
  • Strong typing skills, ability to type 40+ WPM
  • Computer skills - Microsoft Office, strong typing skills
  • Soft skills: organized, ability to multi task

Other Details:
  • 6 months contract

Benefits for Outpatient Referral Coordinator:
  • Immediate enrollment in Health Insurance
  • Dental Insurance
  • Life Insurance
  • Employee Assistance Program (EAP)
  • Access to Investment Accounts
  • Career and educational tools within our Ingenovis ACT (Advocacy) Program

Pay Details: $23.98/hour /hour
Shift: M-F, 8am to 5pm

Interested in being considered?
If you are interested in applying to this position, please click Apply Now for immediate consideration.

For additional consideration, please email a copy of your resume to joey.carulla@healthcaresupport.com with your phone number, the job title and location, and our recruiters will reach out.
Healthcare Support Staffing, LLC is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.

#SLV824

Company DescriptionHealthCare Support is a national recruitment firm that has a singular focus – placing top talent in the dynamic healthcare industry. We place administrative to executive level professionals in the clinical and non-clinical healthcare arena. Launched in 2002, HealthCare Support has quickly grown to be a leader in the healthcare recruitment field and has access to a proprietary database of over 3.5 million talented candidates. Servicing local providers to national organizations, our delivery model is tailored to meet our client’s unique needs.

Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.Company DescriptionHealthCare Support is a national recruitment firm that has a singular focus – placing top talent in the dynamic healthcare industry. We place administrative to executive level professionals in the clinical and non-clinical healthcare arena. Launched in 2002, HealthCare Support has quickly grown to be a leader in the healthcare recruitment field and has access to a proprietary database of over 3.5 million talented candidates. Servicing local providers to national organizations, our delivery model is tailored to meet our client’s unique needs.\r
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Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.

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