Dignity Health UM Referral Coordinator in Bakersfield, California

Overview

The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric, full-service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health’s Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers with a business objective to excel in coordinating patient care in a manner that supports containing costs whil continually improving quality of care and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry-leading technology and integrated administrative systems powered by local human resources that put patient care first.

Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art, flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options, including medical, dental and vision plans, for the employee and their dependents, Health Spending Account (HSA), Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave.

Responsibilities

Accurately processes medical authorizations according to company/department policies and procedures.

Qualifications

  • General knowledge of CPT and ICD9/ICD10 and HCPCS codes as it relates to the processing of medical billing and/or authorizations.

  • Familiar with medical terminology as it relates to IPA’s, PPO’s and HMO’s.

  • Ability to interpret and communicate complex contract or benefit language.

  • General knowledge of QNXT preferred.

  • Strong problem-solving abilities. Ability to identify issues and problems within administrative processes and other relevant areas.

  • Must be attentive to detail, accurate, thorough, and persistent in following through to completion of all activities, demonstrating initiative for completing work assignments.

  • Excellent communication skills; able to read, write, and speak articulately, using established channels of communication and reporting relationships within the organization. Ability to communicate effectively with all levels of internal/external staff, management, members, physicians/physician office staff.

  • General knowledge of Microsoft Office applications; Excel, Word; proficient in the use of Outlook.

  • Thorough knowledge of generally accepted professional office procedures and processes.

  • Ability to use the following general office equipment correctly and safely: desktop computer for data entry and typing, copy machine, scanner, facsimile machine, and telephone equipment.

  • Ability to create professional documents using proper grammar and punctuation.

  • Ability to handle various situations in a professional manner, demonstrating excellent customer service at all times and ability to adapt to change.

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Equal Opportunity

Dignity Health is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected Veteran status or any other characteristic protected by law. For more information about your EEO rights as an applicant, please

If you need a reasonable accommodation for any part of the employment process, please contact us by telephone at (415) 438-5575 and let us know the nature of your request and your contact information. Requests for accommodation will be considered on a case-by-case basis. Please note that only inquiries concerning a request for reasonable accommodation will be responded to from this telephone number.

Job ID 2018-62297

Employment Type Full Time

Department Utilization Review

Hours / Pay Period 80

Facility Dignity Health Management Services Organization

Shift Day

Location Bakersfield

State/Province CA

Standard Hours Mon-Fri (8-5 PM)

Work Schedule 8 Hour