Coordinator, Utilization Management

CorroHealth•FL-Remote, FL

6d•$19 - $20•Remote

About The Position

Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. CorroHealth is the partner of choice to healthcare providers in support of their Revenue Cycle challenges. We solve problems through a customized mix of services, consulting and technology that can change over time to meet any client’s evolving needs.

Requirements

High School Diploma or equivalent.
2 years of experience in hospital related billing/follow-up/healthcare setting/authorization field.
Knowledge of/experience working with managed care contracts
Experience working with customer support/client issue resolution management.
Strong understanding of medical terminology and insurance processes.
Experience working in EMR systems, Epic preferred.
Excellent communication and organization skills.
Strong multi-tasking skills, working in a face paced environment.
Proficiency with MS Office and websystems.

Nice To Haves

Associate degree in healthcare administration or equivalent preferred.

Responsibilities

Manage the Authorization process end to end, from initial notification, entry and submission of required information, follow up all the way to determination and discharge.
Maintain detailed documentation of the record in the EMR system, in the internal CorroHealth system and in the Health Payer portals.
Verify correct eligibility and benefits for patients.
Act as a liaison between the hospital staff and the Health Payer to facilitate information sharing and successful process completion within allocated timeframe.
Review timely filing guidelines regarding the utilization management process.
Track and follow up with payers on pending authorizations to ensure timely responses.
Contact payer to elicit further information regarding status, decisions and remove hurdles in the processing.
Identify and escalate issues that may result in delays or denials.
Manage assigned workload of accounts through timely follow up and accurate record keeping.
Maintain compliance with HIPAA and other healthcare regulations.