Coordinator-clinical Appeals

Loma Linda University Health

San Bernardino, CA, US
Base: $26.03 - $32.51 ph; bonus/equity: not specif...
Utilization management experience
Interqual and milliman criteria knowledge
Medi-cal and medicare contract knowledge
The Coordinator-Clinical Appeals supports the Billing and Collections department by reviewing and appealing clinical denials and retro authorizations

Job Summary

  • The Coordinator-Clinical Appeals supports the Billing and Collections department by reviewing and appealing clinical denials and retro authorizations.
  • Candidates must possess a minimum of three years of experience in utilization management or managed care within a hospital setting.
  • Loma Linda University Health is a faith-based institution seeking individuals who embrace its core values of compassion, excellence, and integrity.

Matching Summary

The Coordinator-Clinical Appeals supports the Billing and Collections department by reviewing and appealing clinical denials and retro authorizations.

Salary

Base: $26.03 - $32.51 per hour; Bonus/Equity: Not specified; Benefits: Eligible for benefits package

Skills & Requirements

Must-have

  • Utilization management experience
  • InterQual and Milliman criteria knowledge
  • Medi-Cal and Medicare contract knowledge
  • Appeal letter composition skills
  • Medical record review capabilities

Nice-to-have

  • Collaborative team player
  • Problem-solving under pressure
  • Quality improvement project participation
  • Faith-based mission alignment

Key Requirements

  • Three years utilization management experience
  • Basic Life Support (BLS) certification
  • Nationally recognized Utilization Management certification preferred
  • California LVN license or Medical Terminology certification preferred

Work Rights

Not specified

Tailored Resume

Cover Letter