UM Coordinator (Inpatient)

Alignment Health

7d•Remote

About The Position

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. Alignment Health is seeking an organized, detail-oriented and customer service oriented inpatient utilization management (UM) coordinator to join the remote UM team. As an inpatient UM coordinator, you will assist with managing census and admissions, retrieve medical records, and discharge planning while working with the case management (CM) supervisor, manager, and director of healthcare services. If you are hungry to learn and grow, want to be part of a growing organization, and make a positive impact in the lives of seniors – we’re looking for you! Schedule: Monday - Friday, 8am - 5pm Pacific Time (Required)

Requirements

Inpatient concurrent review experience
Experience with census and admission management
Experience in discharge planning
Experience entering referrals and prior authorizations.
Experience with Medicare Advantage
Experience with hospital and / or facilities backend admissions
Knowledge of medical terminology
Knowledge of ICD10 and CPT codes
Knowledge of Medicare, HMO, MMO, managed care plans
Computer proficient
High school diploma or general education degree (GED) or (4) years' additional experience in lieu of education.
Proficient in Microsoft Office (Outlook, Excel, Word)
Able to type minimum 50 words-per-minute (WPM).
Organized and detail oriented.
File systematically.
Good interpersonal skills.
Strong written, verbal, and telephonic communication skills
Able to read, write, and speak English fluently.

Nice To Haves

Medical assistant experience preferred
Knowledge working in Access Express / Portal, Epic preferred.
Medical Terminology Certificate preferred.

Responsibilities

Assist team with daily census by entering face sheets for hospitals and skilled nursing facilities (SNF).
Obtain medical records from hospitals and SNF’s.
Attach medical records to authorizations.
Enter referral requests / authorizations in system using ICD 10 and CPT coding.
Monitor fax folders.
Complete and document tasks as assigned by nurse.
Maintain documentation on facilities contacted.
Assist with maintaining and updating member’s records.
Assist with mailing or faxing correspondence to facilities, related to, as needed.
Request medical records from facilities, etc., related to members activities, as needed.
Attend case management presentations and participates, as appropriate.
Recognize work-related problems and contributes to solutions.
Meet specific deadlines and respond to various workloads by assigning task priorities according to department policies, standards and needs.
Maintain confidentiality of information between and among health care professionals.
Be a positive team player.