Utilization Management Coordinator - Casual
About The Position
Altais is hiring a Utilization Management Coordinator for a casual, six-month contract opportunity. The role works closely with the Ambulatory and Concurrent Care, Network Management, Quality Improvement, and Practice Success teams to support efficient authorization processes and navigate insurance requirements with precision and advocacy. The position supports patient-centered care and the promotion of health and wellness. The coordinator handles incoming authorizations received through the Tapestry Link portal or OnBase. Requests may require eligibility or benefit verification and data entry into Tapestry before processing, and must be handled within established turnaround times consistent with Industry Collaboration Effort regulations. The coordinator serves as a primary contact for internal and external customers seeking authorization information or assistance, reviews requests according to established review designations, and prepares denial letters under professional staff supervision. The role also involves contacting provider offices for missing clinical documentation, recording requested information in Tapestry, cross-training with other UM Coordinators to provide process coverage, and maintaining confidentiality in accordance with HIPAA guidelines.
Requirements
- High school diploma.
- Two years of previous experience in utilization management, medical records, medical billing, or a medical office.
- Two to three years of experience with Microsoft Office programs.
- Certificate or equivalent experience in medical terminology, CPT, HCPCS, and ICD coding.
Responsibilities
- Process incoming authorizations received through the Tapestry Link portal or OnBase, including eligibility or benefit verification and data entry into Tapestry when needed, within established turnaround times consistent with ICE regulations.
- Serve as the primary contact for internal and external customers seeking information or assistance related to authorizations.
- Review authorization requests according to established levels of review designation.
- Prepare denial letters under the supervision of professional staff.
- Work with professional staff and customer service to provide accurate technical information to provider offices and internal customers professionally.
- Contact provider offices by telephone to obtain clinical documentation required for medical review and document requested information in Tapestry.
- Cross-train with all UM Coordinators to learn each process and ensure coverage.
- Maintain strict confidentiality of health records and member information and comply with HIPAA guidelines.
Benefits
- Excellent medical, vision, and dental coverage.
- 401(k) savings plan with company match.
- Flexible time off.
- Nine paid holidays.
- Eligibility to participate in the annual bonus program.
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What This Job Offers
Education Level
High school or GED
