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Sr. Utilization Management Coordinator
Location
United States
Posted
97 days ago
Salary
0
Job Description
Sr. Utilization Management Coordinator
Jobgether
This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description This role involves supporting the clinical team by handling administrative and non-clinical tasks essential for processing Utilization Management prior authorizations and appeals. - Monitor incoming faxes for authorization requests - Enter UM authorizations review requests using ICD-10 and HCPCS codes - Verify eligibility and claims history in proprietary platforms - Ensure all necessary documentation is submitted with authorization requests - Contact providers to obtain required medical records - Generate correspondence for member and provider notifications - Complete verbal notifications and document activities - Initiate appeal cases for UM Nurses - Meet deadlines for UM cases as per internal and regulatory standards - Assist UM Nurses with designated tasks - Handle inquiries from call center and other sources - Perform other duties assigned by the UM Director Qualifications - 1 year as a UM Coordinator in a managed care payer environment preferred - Knowledge of ICD-10, HCPCS codes, and medical terminology required - Strong time management and organizational skills to prioritize tasks - Proficient in computer applications like Word and Outlook - Ability to collect data, analyze facts, and draw valid conclusions - Effective written and oral communication skills required - Experience with DMEPOS is desired - Medicare/Medicaid experience is a plus Benefits - Competitive compensation and annual bonus program - 401(k) retirement program with company match - Company-paid life insurance and short-term disability coverage - Medical, Vision, and Dental benefits - Paid Time Off (PTO) and Paid Parental Leave - Sick Time and Paid company holidays - Quarterly company-sponsored events - Health and wellness programs - Career development opportunities
Job Requirements
- 1 year as a UM Coordinator in a managed care payer environment preferred
- Knowledge of ICD-10, HCPCS codes, and medical terminology required
- Strong time management and organizational skills to prioritize tasks
- Proficient in computer applications like Word and Outlook
- Ability to collect data, analyze facts, and draw valid conclusions
- Effective written and oral communication skills required
- Experience with DMEPOS is desired
- Medicare/Medicaid experience is a plus
Benefits
- Competitive compensation and annual bonus program
- 401(k) retirement program with company match
- Company-paid life insurance and short-term disability coverage
- Medical, Vision, and Dental benefits
- Paid Time Off (PTO) and Paid Parental Leave
- Sick Time and Paid company holidays
- Quarterly company-sponsored events
- Health and wellness programs
- Career development opportunities
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