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UM Outpatient Coordinator

The Judge Group Rancho Cucamonga Full-Time
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The Judge Group is looking for 4 UM Outpatient Coordinators in Rancho Cucamonga, CA! 

Job Description:
  • 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. 
  • Any other duties as required ensuring plan operations are successful.
  • Education/License:High School diploma or equivalent required. 
  • Medical Assistant certificate, AA or Bachelor’s is preferred. 
  • Experience:Minimum of three years of experience as a data entry specialist or coordinator, preferably in an HMO or Managed Care setting. 
  • Knowledge/Skills Required: Knowledge of computer applications, including word processing, database and spreadsheets. 
  • Requires knowledge of ICD-9/10 and CPT codes. Managed Care or physician office a must. Good customer service skills.
Please send your most up to date resume to Jaclyn at Email blocked - click to apply

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Job ID: 607387


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The Judge Group is a privately owned, leading professional services firm with nearly 50 years of experience in providing technology, talent, and learning solutions. Our services are successfully delivered through a network of more than 35 offices in the United States, Canada, and India. The Judge Group serves more than 47 Fortune 100 companies and is responsible for 7,000 professionals on assignment annually across a wide range of industries.

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