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Utilization Management Coordinator, PIH Health Physicians, Full Time, Day Shift



Business Office

Whittier, CA
 • 
ID: 12779-977
 • 
Full-Time/Regular

PIH Health is a nonprofit regional healthcare delivery network founded over 50 years ago. Our two campuses including a 548-bed facility in Whittier and a 199-bed facility in Downey, help to provide services to approximately 1.5 million residents in Los Angeles, Orange County and the greater San Gabriel Valley.

 

The UM Coordinator is responsible for processing referrals received from practitioners offices, verify member eligibility and benefits with health plans, verify contracted providers, communicate with practitioner's office to obtain information and provide outcome of referral requests, research appropriate guidelines, draft denial and modification letters, electronic document storage, process incoming and outgoing mail, provide customer service to patients and practitioners over the phone, and other job duties as assigned by the UM Supervisor/Director.


Required Skills

  • Demonstrates attention to detail and strong organizational skills
  • Excellent English communication skills
  • Excellent phone communication skills
  • Typing minimum of 40 words per minute.
  • Data entry and ability to use various word processing programs.
  • Knowledge of medical terminology and coding
     
     
     
     

Required Experience

  • High school graduate or equivalent
  • Minimum of 2 years experience with referrals or similar health care field
  • Familiarity with HMO's and capitation
  • Previous customer service experience
  • Knowledge of health care privacy regulations

 

Beyond the benefits that come with working for the area's leading community healthcare provider – one that also recognizes the need to ensure patient safety and comfort – you'll enjoy an extremely competitive compensation and benefits package.  We are an equal opportunity employer and seek diversity in our workforce.   EOE M/F/D/V

 

This position is located at 6557 Greenleaf Ave., Whittier, CA. View the Google Map in full screen.



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