- High school diploma, GED or equivalent
- Three or more years of managed care experience (e.g., MSO, IPA, or health plan)
- In-depth knowledge of medical terminology
- Understanding of the HMO referral process, eligibility verification, and health plan benefit interpretation
- Strong communication, interpersonal, organizational, and multi-tasking skills
- Exceptional critical thinking, analytical, and problem-solving abilities
- Proven execution and follow-up skills
- Computer proficiency with Microsoft Office
- Ability to cope well with ambiguity and stressful situations
- Ability to maintain confidentiality of patient and business records
- Ability to thrive within a complex academic medical center
- Ability to develop, implement, and evaluate methods and systems to improve efficiency
- Ability to lead and facilitate cross-functional workgroups and other meetings
- Expertise in achieving compliance with regulatory requirements
- Strong service orientation
-
Denial Coordinator
2 weeks ago
Astrana Health Monterey Park, United States· Job Title: Denial Coordinator · Department: Health Services - DenialsAbout the Role: · Astrana Health is looking for a Denial Coordinator. This role will report to a Manager-Denial and enable us to continue to scale in the healthcare industry. This is a hybrid role where the ...
-
Denial Coordinator
3 weeks ago
Astrana Health Monterey Park, United States· Job Title: Denial Coordinator · Department: Health Services - DenialsAbout the Role: · Astrana Health is looking for a Denial Coordinator. This role will report to a Manager-Denial and enable us to continue to scale in the healthcare industry. This is a hybrid role where the ...
-
Utilization Management Denial Coordinator
3 days ago
UCLA Health Los Angeles, United StatesTake on a high-impact role within a world-class health organization. Help drive the continued delivery of exceptional patient care. Take your career to the next level. You can do all this and more at UCLA Health. In this key position, you will be the Management, Coordinator, Medi ...
-
Referral Coordinator
3 weeks ago
PHS Med Jobs Los Angeles, United States**Referral Coordinator | Full-Time | Los Angeles, CA** · **About the Referral Coordinator Role**: · ProHealth Staffing is seeking a Referral Coordinator who is passionate about making a significant impact in the lives of patients in the immediate underserved communities while adv ...
-
Utilization Review
3 weeks ago
Codemax Medical Billing Los Angeles, United StatesJob Title: Utilization Review Follow Up Specialist · Reports to: Utilization Review Follow-Up Supervisor · Employment Status: Full-Time · FLSA Status: Non-Exempt · - Job Summary:_ · - Duties/Responsibilities:_ · - Monitors and manages pending utilization review and prior authoriz ...
-
Ecm Referral Specialist
1 week ago
Titanium Healthcare Los Angeles, United States**Who we are**: · We are a healthcare company that puts heart and compassion above all else. Millions of Americans just aren't getting the medical care they need. We're on a mission to change that. For patients that means exceptional support and better care. For providers it mean ...
-
Utilization Management Specialist
2 weeks ago
Keck Medical Center of USC Los Angeles, United StatesThe Utilization Management Specialist coordinates communication with admitting financial counselors, case management, patient financial services, and payers to ensure all inpatient services provided by the hospital are authorized by appropriate payer. The Utilization Management S ...
-
Business Office Manager
2 weeks ago
Rockport Healthcare Services Los Angeles, United States**$5000 sign on bonus available for new hires hired by 5/31/2024, will be payable after 6 months of employment** · **Position Summary**: · The Business Office Manager (BOM) is responsible to record all facility revenue accurately and ensure timely collection of revenue. · Essenti ...
-
Resident Services Coordinator I
2 weeks ago
TELACU Los Angeles, United StatesTELACU Residential Management, Inc. (TRM) has developed thousands of apartment homes, creating beautiful residential communities throughout California. These communities are operated by TELACU Residential Management, Inc. (TRM), which provides the highest levels of in-house overs ...
-
Remote Insurance/collections Specialist
2 weeks ago
Conduent Payment Integrity Solution Inc. Los Angeles, United StatesThrough our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on them. You have an opportunity to persona ...
-
Kaiser Permanente Los Angeles, United States**Job Summary**: · Ensures the teams work adheres to legal, compliance, and reporting standards, organizes feedback from team and escalates to leadership. Leads research and analysis of moderately complex financial data; monitoring team(s) on the proper use of expenditures. Revie ...
-
Patient Accounts Representative- Remote
6 days ago
TeamHealth Los Angeles, United States**Job Snapshot**: · **Employee Type**: · Full-Time · - **Location**: · Los Angeles, CA · - **Job Type**: · Health Care · - **Experience**: · Not Specified · - **Date Posted**: · 4/29/2024 · - TeamHealth is a physician-led, patient-focused company. Founded by doctors, for doctors, ...
-
Director, Accounts Receivable
1 week ago
The Oncology Institute of Hope and Innovation Los Angeles, United StatesFounded in 2007, The Oncology Institute of Hope and Innovation (TOI) is advancing oncology by delivering highly specialized, value-based cancer care in the community setting. TOI is dedicated to offering cutting edge, evidence-based cancer care to a population of more than 1.7 mi ...
-
Lending Assistant
4 days ago
Wallis Bank Los Angeles, United States**Job: Lending Assistant - Location: Los Angeles, CA** · At Wallis Bank we are a full-service community bank with the ability to serve the needs of all our customers, from the smallest rural customers to the largest international customers. We are looking for a well qualified Len ...
-
Associate Registrar for Outgoing Loans
2 days ago
J. Paul Getty Trust, The Los Angeles, United StatesDiversity, Equity, Accessibility, and Inclusion at Getty: Getty believes diversity, equity, accessibility and inclusion are essential to our excellence and to the execution of our mission. The Getty community values differences in the pursuit of inquiry and knowledge, mutual unde ...
-
Pharmacy Technician
4 days ago
Pharmacy Alternatives Anaheim, United StatesOur Company: · Pharmacy Alternatives · Overview: · Provides a variety of pharmacy technician, data entry, billing and IV technician functions to support clinical and business operations for the assigned region. Responsible for coordinating, and may also train these activities wit ...
-
Ccs Coordinator
3 weeks ago
Astrana Health Monterey Park, United StatesJob Title: CCS Coordinator · Department: Health Services - ICM · **About the Role**: · The CCS Coordinator will assist the inpatient case management department in assigned areas of responsibility, including creation of authorizations/cases, tracking/maintaining records, conductin ...
-
Office Coordinator
5 days ago
Keck Medical Center of USC Alhambra, United StatesAs an integrated part of the department, this position provides coordination of office flow and activities. Offers support in coordinating and maintaining files and data activities in an efficient manner. Provides clerical support to the department staff. · The Office Coordinator ...
-
Director of Rehabilitation- Ot- Pt
2 weeks ago
Pasadena Park Healthcare & Wellness Center Pasadena, United States**GENERAL PURPOSE**:The Director of Rehabilitation is responsible for internal departmental communication and operations, facilitating and coordinating patient care, and quality assurance. · **ESSENTIAL JOB FUNCTIONS**: · **Develops and maintains systems which build and enhance t ...
-
Dental Biller/ Dental Treatment Planer and
3 weeks ago
Joseph Goodman DDS Beverly Hills, United StatesLooking for an expert dental biller and front office staff. We have Dentrix. ( no remote work please) · Need an expert with coding and backbilling for dental office in Beverly Hills. · Must be efficient in dentrix. · Prefer 4 to 5 days in office work. · - Review and process medic ...
Utilization Management Denial Coordinator - Los Angeles, United States - University of California
Description
Take on a high-impact role within a world-class health organization. Help drive the continued delivery of exceptional patient care. Take your career to the next level. You can do all this and more at UCLA Health.In this key position, you will be the primary point of contact for receiving and resolving member denials.
You will review denials for accuracy, confirming the receipt of necessary documentation to support the denial and ensuring compliance with all contractual obligations and state and federal laws/regulations.
You will extrapolate and summarize essential information for the UM Manager and Medical Director and regularly meet with them for clinical guidance in resolving cases.
You will also document appeals in the tracking system and maintain relevant statistical data.Salary Range:
$ $43.68 Hourly
Qualifications We're seeking a results-driven, quality-focused, self-motivated team player with:
UCLA Health is a world-renowned health system with four award-winning hospitals and more than 250 community clinics throughout Southern California, as well as the David Geffen School of Medicine.
Through the efforts of our outstanding people, we have become Los Angeles' trusted provider of exceptional, compassionate patient care. If you're looking to experience greater challenge and fulfillment in your career, you can at UCLA Health.#J-18808-Ljbffr