Non Clinical Intake Coordinator

Job description

Overview
We are looking for a part-time Non-Clinical Intake Coordinator III who is available to work weekends and holidays This will be a hybrid position You must be a CMA or CNA a certificate is required. You will support the Clinical Intake staff in the processing of Health Plan referrals for medical services, durable medical equipment, and specialty care. This position will provide the UM Department with administrative support in the implementation of the authorization process to ensure accuracy of service determinations, limitations of Health Plan coverage, and timeliness in the communication and decision-making process. This position will play a key role as provider and member liaison UM process.

Essential Functions

Screen calls providers and members regarding the UM process

Obtain Referral information from providers and members to implement and facilitate the authorization process

Act as a liaison to members, community providers, and employees

Reviews specified referral types using established criteria for purposes of preauthorization of payment when indicated routes requests to clinical intake coordinators for approval or auto-authorizations.

Obtains additional medical information for clinical staff for preparation of authorizations for Clinical Intake Coordinator review

Benefits interpretation to include coordination of care for medically necessary services that are not covered

Monitors, tracks, and processes provider service appeals.

Acts as a resource to Non-Clinical Intake Coordinator Level I and Non-Clinical Intake Coordinator Level II staff.

Reviews member history and eligibility and previous referral authorizations.

Job Type: Part-time

Pay: $20.00 - $22.00 per hour

Schedule:
? 8-hour shift
? Weekends only
? Holidays

Work Location: Hybrid remote in Bakersfield, CA 93309

Company DescriptionWe are a full-service staffing firm. Let us help you find the perfect position!

https://cazadorconsultinggroup.com/

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