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Experis

Temporary Coordinator - Utilization Management Outpatient

Experis, Rancho Cucamonga, California, United States, 91739


Job Title: Utilization Management OutpatientDuration: 6 monthsLocation: Rancho Cucamonga, CA (Hybrid, Twice in a month)Pay rate: $23.98/hr.

We are looking for an Utilization Management Outpatient

to join one of our Fortune 500 Healthcare clients.

Key Responsibilities:Responsible for monitoring the Right Fax Server. Ensuring all referrals are processed in a timely manner and ensuring compliance with appropriate turnaround timeframes.Responsible for checking the referral form for completeness, obtaining missing demographic information as needed, and initial attempts at coding any uncoded referrals.Responsible for meeting accuracy standards for appropriate authorizations of referrals at the UM Coordinator level.Responsible for representing the Inland Empire Health Plan in a friendly and professional manner while answering the 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.Qualifications:Education & Experience

Minimum of three (3) years of experience as a data entry specialist or coordinatorHigh school diploma or GED requiredKey Qualifications

Requires knowledge of ICD-9/10 and CPT codesManaged Care or physician office a mustSkilled in computer applications, including word processing, database, and spreadsheetsGood customer service skills

We are looking for the candidate who are eligible to work with any employers without sponsorship .

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