Utilization Management Resource Coordinator - Sharp Spectrum Corporate Offices - Full-Time - Variable Shift

Sharp HealthCare•San Diego, CA

1d•$28 - $39

About The Position

This position supports the system centralized utilization management department to meet division and organizational objectives, facilitate effective communication between department staff and the internal and external customers to the department, including but not limited to the business office, revenue cycle, physicians and payers. This position is accountable to ensure timely follow up on payer requests for clinical documentation, optimal inbound and outbound fax management to mitigate denials and ensure established timeliness response metrics are met, and reconciliation of hospital authorizations. Identification and escalation of concerns to the ICM System Centralized Utilization Management team to mitigate denials. Assists in capturing administrative days under the direction of the UM CM's. A key member of the UM customer service team to meet and exceed the customer's expectations.

Requirements

H.S. Diploma or Equivalent

Nice To Haves

Health related education.
Successful completion of Medical Assistant Program or equivalent.
2 Years hospital experience.
2 Years Medi-Cal experience.
Bilingual preferred.
Knowledge of hospital payors preferred.
General filing knowledge.
Demonstrated proficiency in Microsoft Word, Microsoft Excel, Microsoft Outlook, and other software programs.
Excellent organization, managerial and time management skills with the ability to multi-task.
Excellent analytical, problem solving and supervisory skills, knowledgeable of medical terminology, and current standards of clinical practice, professional counseling, mentorship and resource allocation.
Knowledgeable in the use of ICD-10, CPT4, and HCPC coding systems.
Proficient in typing and computer data entry (45 wpm).
Excellent verbal and written communication skills.
Ability to read, speak, and hear English clearly.
Able to work independently in research and decision making with minimal direction from higher level of staff.