An employeris looking for an Inpatient UM Coordinator to work for a large healthcare company in Irvine, CA. In this role, you will be responsible for verifying insurance and benefits for specific procedures. This individual will be entering referral requests into online systems and approve requests per clinical criteria guidelines for pass-through services, under the supervision of the team of Nurses. They may also be assisting with retro review claims process as needed and doing authorizations. This individual for the Inpatient UM Coordinator position should have experience working with case managers, SNF, discharge orders, home health (non-clinical). In the Outpatient UM Coordinator position these individual should have knowledge working with health plans, doing referrals, etc.
2+ years Healthcare experience (Authorizations, Referrals, Transportation, DME, etc)
Health Plan experience (Blue Cross, Blue Shield, Scan, etc)
High School Degree
Medical Terminology Understanding
Understanding of health plan eligibility and health care benefits