UM Coordinator Transportation
Ontario, CA 91761
Kinetic Personnel Group is currently recruiting for an UM Coordinator Transportation for a public health agency that has won awards for its quality-of-work-and-life-balance. This four-billion-dollar non-profit company also offers CalPERS benefits on the full time side. This position requires the ability to multitask ensuring that the information on the request is correct and complete. Verifying the Doctor/Facility s address matches the address in the system to ensure the Member is transported to the correct address, calling the Provider to verify appointments when necessary and ensuring that the Members are transported at the correct level/mode to ensure the Member s safety. The Utilization Management Coordinator Transportation is responsible to monitor the Transportation authorization queue to ensure all Transportation requests are processed timely and are following standard regulatory requirements. The Coordinator - Utilization Management Transportation is responsible to communicate with the vendor that manages the Transportation Benefit to verify benefit exhaustion.
- Responsible for reviewing and determining need for transportation requests initiated by a Provider or the Member directly.
- Responsible for out bound calls to both Members and Providers to obtain necessary information to determine medical necessity of transportation requests.
- Collaborates with the Medical Directors for transportation requests that do not meet criteria for final decision.
- Ensures alerts are properly created for Members that meet criteria for continued transportation.
- Monitors the Transportation authorization queue to ensure transportation requests are processed timely following all regulatory timeframes.
- Responsible for covering the transportation Member phone queue as directed by management
- Responsible for covering the transportation Vendor phone queue as directed by management.
Requirements (must have):
- Possession of a high school diploma or equivalent.
- Two (2) years customer service experience in medical clinics, hospitals, or IPAs
- Bilingual (English/Spanish).
- Medical Assistant Certification, Associate from an accredited institution.
- Managed care setting experience preferred. Knowledge of Utilization Management including referral process, ICD-10 and CPT codes.
- Type 45 WPM.