Coordinator - Referral Coordinator (Bilingual) 25-00409

Under the general direction of the UM Operations Manager, UM Regulatory & Compliance - CCA, the Coordinator - UM Letter Review - CCA is a high paced position that requires timely processing of denied and partially approved referral requests for Medicare and MediCal lines of business. The Letter Review Coordinator ensures accurate processing of denials for the UM Department. This position requires that one be organized with the ability to multi-task and have a high attention to detail with a working knowledge of ICD.10, CPT Coding and Medical Terminology.

• Minimum of two (2) years of experience as a data entry specialist. Experience with Commercial Plan coverage required
• Experience as a data entry specialist, preferably in an HMO or Managed Care setting
• Utilization Management experience preferred
• High school diploma or GED required
• This is a bilingual position. Identified bilingual team members in this role must take a language proficiency assessment and must receive a passing score.

• Knowledge of CMC and Medi-Cal/managed care environment
• Knowledge of Commercial managed care coverage
• Requires knowledge of ICD-10, CPT codes and medical terminology
• Understanding of and sensitivity to multicultural community
• Skilled in computer applications, including word processing, database, and spreadsheets
• Excellent communication and interpersonal skills
• Strong organization and high attention to detail
• Ability to multitask and high degree of patience
• Preferably 9-6 working schedule
• Position is eligible for telecommuting/remote work location upon completing the necessary steps and receiving HR approval