About the role
Under direction of the Director of Health Services and the Health Services Manager, the Non-Clinical Intake Coordinator III will support the Clinical Intake staff in the processing of Health Plan referrals for medical services, durable medical equipment, and specialty care. This position will provide the UM Department with administrative support in the implementation of the authorization process to ensure accuracy of service determinations, limitations of Health Plan coverage, and timeliness in the communication and decision-making process. This position will play a key role as provider and member liaison to the UM process. This position will provide administrative support to the Utilization Management Department, a licensed health maintenance organization (HMO).
Essential Duties and Responsibilities
Screen calls from providers and members regarding the UM process.
Obtain referral information from providers and members to implement and facilitate the authorization process.
Act as liaison to members, community providers, and employees to the UM clinical staff.
Assigns diagnostic and procedural codes using ICD10, and CPT coding classification system for service requests. Requests input from the Clinical Intake Staff when needing direction or clinical expertise.
Reviews specified referral @types using established criteria for purposes of pre-authorization of payment, when indicated routes requests to Clinical Intake Coordinators for approval or auto-authorizations.
Benefits interpretation to include coordination of care for medically necessary services that are not covered under the Plan (e.g. CCS, and State Waiver Programs.)
Obtains additional medical information for clinical staff for preparation of authorizations for Clinical Intake Coordinator review.
Coordination of Health Plan services between UM Department and KHS Member Services and Provider Relations.
Reviews member history and eligibility and previous referral authorizations.
Monitors, tracks, and processes provider service appeals.
Ensures accurate data entry of authorizations in the QNXT system.
Acts as a resource to Non-Clinical Intake Coordinator Level I and Non-Clinical Intake Coordinator Level II staff.
Adheres to Code of Ethics and Business Conduct and all company policies, e.g., confidentiality, attendance, safety/security, use of equipment and technology, appearance and demeanor.
Performs other job-related duties as assigned.
Adheres to all company policies and procedures relative to employment and job responsibilities.
Employment Standards
Education and experience:
High School Diploma from an accredited school or equivalent.
Medical Assistant associate's degree/diploma or Medical Assistant Certificate or Certified Nurse Assistant (CNA) required.
Minimum of two (2) years of experience in a managed care setting.
Data entry and computer experience of at least two years.
Proficient in ICD-9, ICD-10, and CPT coding procedures.
Experience with medical terminology.
westpriority26
Job Type & Location
This is a Contract to Hire position based out of Bakersfield, CA.
Pay and Benefits
The pay range for this position is $26.00 - $26.00/hr.
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: - Medical, dental & vision - Critical Illness, Accident, and Hospital - 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available - Life Insurance (Voluntary Life & AD&D for the employee and dependents) - Short and long-term disability - Health Spending Account (HSA) - Transportation benefits - Employee Assistance Program - Time Off/Leave (PTO, Vacation or Sick Leave)
Workplace Type
This is a hybrid position in Bakersfield,CA.
Application Deadline
This position is anticipated to close on Jun 12, 2026.
About TEKsystems
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
About TEKsystems and TEKsystems Global Services
We're a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We're a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We're strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We're building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.
Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.
