Medical Assistant Authorization Coordinator

4 weeks ago


Rancho Cucamonga, California, United States Alura Workforce Solutions Full time

Job Summary

The Authorization Coordinator Medical Assistant will work under the general direction of the UM Outpatient Manager and Supervisor, processing authorization requests, verifying eligibility, and obtaining additional information as requested by Medical Management or Utilization Management Nurses.

This position requires strong organizational skills, the ability to multitask, and a working knowledge of ICD-9/10, CPT Coding, and Medical Terminology.

The Authorization Coordinator Medical Assistant will also ensure that provider calls are responded to in an accurate and timely manner, maintaining the highest level of customer service.

Responsibilities include monitoring the Right Fax Server, ensuring all referrals are processed in a timely manner, and ensuring compliance with appropriate turnaround timeframes.

The Authorization Coordinator Medical Assistant will be responsible for checking the referral form for completeness, obtaining missing demographic information as needed, and initial attempts at coding any uncoded referrals.

Meet accuracy standards for appropriate authorizations of referrals at the UM Coordinator level.

Represent the Inland Empire Health Plan in a friendly and professional manner while answering calls for the Utilization Management Department.

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.

Assist Management or Utilization Management Nurses as requested.

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 accredited institution preferred.
  • Medical Assistant certificate preferred.
  • Requires knowledge of ICD-9/10 and CPT codes. Managed Care or physician office a must.
  • Skilled in computer applications, including word processing, database, and spreadsheets. Good customer service skills.

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