Health Services Authorization Coordinator I
Job description
We have an opportunity to join the Alliance as a Health Services Authorization Coordinator I in the Utilization Management and Complex Case Management Department.
WHAT YOU'LL BE RESPONSIBLE FOR
- You will process incoming treatment and referral authorization requests and verify member plan eligibility
- Perform basic research on member authorization requests
ABOUT THE TEAM
We determine medical necessity and benefit coverage for our members based on industry standards.
WHAT YOU'LL NEED TO BE SUCCESSFUL
To read the full position description, and list of requirements click here.
- Knowledge of:
- Standard business office practices and equipment
- Medical terminology or billing codes procedures
- Principles and practices of customer service
- Ability to:
- Verify eligibility information utilizing various organizational sources
- Interpret, explain and apply processes, policies and procedures
- Pay close attention to detail and utilize effective organizational skills
- Produce and maintain accurate records
- Demonstrate strong customer service skills, specific to telephone inquiries
- Education and Experience:
- High School Diploma or equivalent
- A minimum of two years of experience in the health care field (an Associate's degree may substitute for one year of the required experience or an equivalent combination of education and experience which would provide the required knowledge, skills and abilities may be qualifying
OTHER DETAILS
- While this position is connected to one of our Alliance offices, we are in hybrid remote/in-office work environment right now and we anticipate that the interview process will take place remotely.
- Our Alliance office locations have officially re-opened as of May 2, 2022 and while some employees may work in full-time telecommute schedules, attendance at quarterly company-wide events or department meetings will be expected.
- Based on the nature of work, this position may require onsite presence, which is dependent on business need. Details about this can be reviewed during the interview process.
COVID-19 Vaccine Requirement: At this time, the Alliance is requesting the vaccination status of its workforce for COVID-19. While this position doesn't require vaccination as a condition of employment, all employees are required to report their vaccination status, and, if vaccinated, provide proof of vaccination.
Scotts Valley pay range
Merced pay range
Salinas pay range
Additionally, all positions at the Alliance are required to meet these minimum qualifications.
OUR BENEFITS
- Medical, Dental and Vision Plans
- Ample Paid Time Off
- 12 Paid Holidays per year
- 401(a) Retirement Plan
- 457 Deferred Compensation Plan
- Robust Health and Wellness Program
- Onsite EV Charging Stations
- And many more
ABOUT US
We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us.
Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve members in Merced, Monterey and Santa Cruz counties. To learn more about us, take a look at our Fact Sheet.
At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.
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