Utilization Management Coordinator I - Utilization Management
About The Position
JOB SUMMARY: Under the supervision of the Utilization Management (UM) Operations Supervisor, the UM Coordinator I's primary job function is to support UM operations by performing any non-clinical tasks. This includes, but is not limited to, initial authorization processing, (data entry, eligibility verification, benefits verification, and requesting required supporting documents from submitting provider offices), answering the phone (including all provider calls regarding authorization processing, claims related phone calls, and any other calls received via the provider call center lines), and appropriately processing required UM notifications (letters, faxes, etc.).
Requirements
- H.S. Diploma,GED,or Equivalent
- 1 Year of Experience
- Strong critical thinking skills
- Excellent communication and interpersonal skills
- Associate's Degree or Bachelor's Degree can be accepted in lieu of experience
- Demonstrated commitment to valuing diversity and contributing to an inclusive working and learning environment
Nice To Haves
- Associate's Degree
- Computer skills, including Excel, EZ Cap, Word, Outlook, and data entry systems
- Previous experience in the health care field, such as hospital, medical group, health insurance, or other Risk Bearing Organization (RBO)
- Knowledge of medical terminology, ICD-10 codes, CPT Codes, HCPC Codes, Health Plan benefits, or claims
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
1,001-5,000 employees
