CCS Coordinator Hybrid

Company: ApolloMed
Location: Monterey Park
Posted on: January 25, 2023

Job Description:

Job Title: CCS CoordinatorDepartment: Health Services - ICMAbout the Role:We are currently seeking a highly motivated CCS Coordinator. This role will report to a Supervisor - CCS and enable us to continue to scale in the healthcare industry. This is a hybrid role where the expectation is to work both in office and at home on a weekly basis.You are:Comfortable with ambiguity and biased towards actionRelentlessly resourcefulGrowth-orientedMission-drivenWhat You'll Do:Comply with UM policies and procedures. Annual review of selected UM policiesProcess Routine & Urgent treatment authorization requests according to the NMM Policy & Procedure Manual based on UM Level review processMeet requirement production requirements, working 30-45 cases per day, such as calling for records, completing the SAR and submitting, following up on previously submitted cases, creating cases for those accepted in to the CCS programPrepare files for health plan audits as neededAccurately review, screen and process referrals in accordance with IPA and health plan TAT guidelines and completed daily assignments with accuracy & qualityKnowledgeable of the California Children's Service (CCS). Understanding of the requirements to enroll in the programUnderstanding of the Early Start Program and Regional Centers, coordinate and process referrals as neededReview monthly report to capture possible Early Start or Regional Center referrals. Send letter to the PCP and the member informing them of the programsWork with the provider to obtain required information to submit to CCSSubmit required CCS application, release authorization while pending SARTrack and monitor the submissions and follow up as per the internal P&PTrack UM TAR referrals that were CCS approved conditionsWork with Health plans to obtain the required SAR'sReview daily reports for potential members with CCS valid conditionsResponsible for verification to include but not limited to: benefit matrix through DOFR, eligibility, provider status (contracted/non-contracted), carved out and othersResearch problems for treatment authorizations request in a timely fashionAttend to provider and interdepartmental calls in accordance with exceptional customer serviceCoordinate all UM activities as assignedAssist with obtaining required documents for CCS, CPSP and Early Start health plan auditsAttend to provider and interdepartmental calls in accordance with exceptional customer servicePerforms other duties, projects and actions as assignedMaintains strictest confidentiality at all timesMinimum Qualifications:High School Graduate or equivalentA minimum of two years experienced in managed care environment to include but not limited to an IPA or MSO preferredCurrent knowledge of Managed Care UM proceduresKnowledge of the Medi-Cal Linked Programs to include CCS, ESPRCKnowledge of medical terminology, RVS, CPT, HPCS, ICD-10 codesProficient with Microsoft applications' and EZCAPGood organizational skills.Good verbal and written communication skills.Must have the ability to multitask and problem solve in a fast pace work environmentPersonal & Professional QualitiesWho We Are: ApolloMed (NASDAQ: AMEH) is a physician-centric, technology-powered healthcare management company. We are building and operating a novel, integrated, value-based healthcare delivery platform to empower our physicians to provide the highest quality of end-to-end care for their patients in a cost-effective manner. Our mission is to combine our clinical experience, best-in-class delivery network, and technological expertise in order to improve patient outcomes, increase access to healthcare, and make the US healthcare system more efficient.Our platform currently empowers over 10,000 physicians to provide care for over 1.2 million patients nationwide. Our rapid growth and unique position at the intersection of all major healthcare stakeholders (payer, provider, and patient) gives us an unparalleled opportunity to combine clinical and technological expertise in order to improve patient outcomes, increase access to quality healthcare, and reduce the waste in the US healthcare system.Our Values:Patients FirstEmpowering the Independent ProviderBe InnovativeOperate with Integrity & Deliver ExcellenceTeam of OneEnvironmental Job Requirements and Working Conditions:Our organization follows a hybrid work structure where the expectation is to work both in office and at home on a weekly basis. The office is located at 1600 Corporate Center Dr, Monterey Park, CA 91754.The target pay range for this role is $16.50 - $28.50 per hour. This salary range represents our national target range for this role.ApolloMed is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at to request an accommodation.Additional Information:The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.

Keywords: ApolloMed, Monterey Park , CCS Coordinator Hybrid, Other , Monterey Park, California