Health Services Authorization Coordinator

3 weeks ago


Merced, California, United States Central California Alliance for Health Full time
About the Role

We are seeking a highly skilled Health Services Authorization Coordinator to join our Utilization Management and Complex Case Management Department. As a key member of our team, you will play a critical role in processing incoming treatment and referral authorization requests, verifying member plan eligibility, and performing basic research on member authorization requests.

Key Responsibilities
  • Process incoming treatment and referral authorization requests
  • Verify member plan eligibility
  • Perform basic research on member authorization requests
  • Determine medical necessity and benefit coverage for members based on industry standards
  • Interpret, explain, and apply processes, policies, and procedures
  • Verify eligibility information utilizing various organizational sources
  • Produce and maintain accurate records
  • Demonstrate strong customer service skills, specific to telephone inquiries
Requirements
  • High School Diploma or equivalent
  • A minimum of two years of experience in the healthcare field
  • Knowledge of standard business office practices and equipment, medical terminology or billing codes procedures, and principles and practices of customer service
About Us

We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality healthcare that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us.

At Central California Alliance for Health, we are an equal employment opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender perception or identity, national origin, age, marital status, protected veteran status, or disability status.


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