Coordinator - ITC

Overview:
What you can expect 

 

Find joy in serving others with IEHP We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience

 

Under the general direction of the Manager and Supervisor in the Integrated Transitional Care department, the Coordinator - Integrated Transitional Care is a high paced position that requires timely processing of Authorization requests, verifying eligibility, obtaining additional information as requested by the Integrated Transitional Care Nurse. This position requires that one be organized with the ability to multitask with a working knowledge of ICD 10, CPT coding and Medical Terminology. The Coordinator - Integrated Transitional Care will work as an extension of the clinical team to complete all non-clinical functions as indicated, in addition to collaboration with, inter-departments to ensure member needs are met while simultaneously building strong peer relationships.

 

Key Responsibilities:

 

1. Monitor the Right Fax server, EDI Interface, and medical management system intake to all face sheets are processed in a timely manner. 
2. Ensure that hard copy and electronic face sheets are complete and accurate to reflect current Member demographic information. 
3. Review of the daily census report in an effort to eliminate duplicates or other admission received from all contracted and non-contracted facilities not required by the health plan. 
4. Cover Cisco ACD Queue telephone lines and phone queues. 
5. Check eligibility and assigning Authorization to appropriate ITC nurse based on the Far tool.
6. Attach reviews and orders into the medical management system for review by the ITC nurse
7. Review and approve service requests within the ITC Coordinator scope as indicated by the Utilization Management Guide approved by the Utilization Management Subcommittee. 
8. Obtain Member discharge dates through daily calls, Electronic Medical Record or memo submissions to contracted and non-contracted facilities. 
9. Meet the performance measurement standards for productivity and accuracy as well as timely processing of inpatient authorizations, inpatient service requests, and discharges. 
10. Assist with the referral process by contacting provider by phone fax or email to request additional medical information as needed.
11. Set up hospital follow up appts for Member if needed and providing that information to the Member. Documenting the call within the medical management system.

 

Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Additional Benefits:
 

Perks

 

IEHP is not only committed to healing and inspiring the human spirit of our Members; we also aim to match our Team Members with the same energy by providing prime benefits and more.

 

CalPERS retirement

457(b) option with a contribution match

Generous paid time off- vacation, holidays, sick

State of the art fitness center on-site

Medical Insurance with Dental and Vision

Paid life insurance for employees with additional options

Short-term, and long-term disability options

Pet care insurance

Flexible Spending Account – Health Care/Childcare

Wellness programs that promote a healthy work-life balance

Career advancement opportunities and professional development

Competitive salary with annual merit increase

Team bonus opportunities

Qualifications:
Education & Experience

Minimum of two (2) years of experience as a data entry specialist

High School Diploma or GED required

 

Key Qualifications

Must have a valid California Driver's License

Requires knowledge of ICD 10 and CPT codes

Managed Care or physician office a must

Skilled with computer applications, including word processing, database, and spreadsheets

Good customer service skills

 

 

 

 

Start your journey towards a thriving future with IEHP and apply TODAY

Pay Range:
USD $23.98 - USD $30.57 /Hr.

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