Coordinator, Utilization Management

CorroHealth•PA-Remote, PA

4d•Remote

About The Position

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. This position is remote within US only. The required schedule is 8:00 AM to 5:00 PM EST either Sunday - Thursday or Tuesday - Saturday. The company cannot guarantee a preferred shift and some holiday coverage is required.

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 web systems.

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.