Coordinator, UM Intake

Evolent

1d•Remote

About The Position

The Coordinator, UM Intake at Evolent provides support to the Utilization Management Team. The coordinator will support administrative operations by ensuring the efficient intake, review and processing of documents. The general administrative support given will contribute to the overall effectiveness of the department.

Requirements

A high school diploma or GED.
1 – 3 years of experience in a population management or managed care/insurance or hospital medical management department setting.
Basic knowledge of medical records with the ability to locate and verify member details.
Familiarity with health insurance lines of business (Commercial, Medicare, Medicaid) to correctly identify and classify incoming documents based on plan type.
Working knowledge of medical coding system including CPT/HCPCS codes to differentiate between medical and pharmacy prior authorization requests.
Ability to adapt to fluctuating situations and perform work of a detailed nature, while avoiding errors.
Proficient using computer and Windows PC applications (Outlook, Word, Excel and OneNote), which includes strong keyboard and navigation skills.
Team oriented, demonstrates a strong work ethic and committed to productivity.

Nice To Haves

Demonstrated ability meeting established goals while balancing a workload and prioritizing assignments in a remote environment.

Responsibilities

Prepare inbound faxes for coordinator processing which includes reviewing content and label editing to ensure accurate document classification.
Review Service Level Agreement Grids to determine appropriate turnaround timeframes (TAT) based on health plan, product type, line of business, code and priority.
Accurately calculate and document the TAT.
Monitor the failed fax dashboard to identify unsuccessful transmissions and coordinate the re-sending of correspondence via appropriate channels.
Oversee and respond to requests in a shared email inbox by reviewing clinician inquires, retrieving requested clinical documents and attaching them for timely case review.
Assist with additional administrative tasks as assigned, demonstrating flexibility, strong attention to detail, and the ability to adapt to evolving department needs.
Meet established UM Intake Objective and Key Results.