UM Administration Coordinator

Become a part of our caring community and help us put health first
 The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.

The UM Administration Coordinator 2 provides non-clinical support for the policies and procedures ensuring best and most appropriate treatment, care or services for members. Decisions are typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.

Key Responsibilities

• Attaching faxes for chart reviews for the nursing team

• Make inbound/outbound calls daily to providers to verify clinical information/discharge date and admission status

• Document calls and attach clinical information received

• Manage queues and assign cases

• Request clinical information from providers/facilities

• Create and send out written correspondence

• Ability to multitask and prioritize in a high production environment

• Collaborate with multiple roles/departments/providers/team members

Use your skills to make an impact
 

Required Qualifications

• 1+ years of healthcare experience (working for a health plan, organization or provider)

• 1+ years of administrative, telephonic customer service and/or healthcare experience

• Must be able to work a shift, Monday -Friday 8:00 a.m. - 5:00 p.m. EST or CST

• Excellent verbal and written communication skills

• Comprehensive knowledge of Microsoft Word, Outlook, and Excel with the ability to type and enter data accurately, as well as the ability to quickly learn new systems

Preferred Qualifications

• Associate’s degree

• 1+ years of experience with Utilization Review and/or Prior Authorization, preferably with a managed care organization

• Proficient utilizing electronic medical record and documentation programs

• Proficient and/or have experience with medical terminology and/or ICD-10 codes

Additional Information

• Hours for this role are Monday-Friday (8:00 a.m. - 5:00 p.m. EST/CST)

Interviewing Technology:

​As part of our hiring process for this opportunity, we will be using an interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

Work At Home / Internet Information:

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees …