Utilization Management Coordinator - Casual

As a UM Coordinator, you will work closely with our Ambulatory and Concurrent Care, Network Management, Quality Improvement and Practice Success teams. Your responsibilities include driving efficient authorization processes, navigating insurance requirements with precision and advocacy. This role is a Casual, 6-month contract opportunity.

Responsibilities

Responsible for all incoming authorizations, whether received via Tapestry Link portal or OnBase; Function as the primary contact for internal and external customers requesting information or assistance related to authorizations; Review authorization requests per established level of review designation; Prepare the denial letters under the supervision of the professional staff; Works closely with professional staff and customer service to provide accurate technical information to provider offices and internal customers; Contact provider offices by telephone for missing clinical documentation necessary for medical review and document information requested in Tapestry; Cross train with all UM Coordinators to learn each process completely; Ensure strict confidentiality of all health records, member information and meet HIPAA guidelines

Requirements

High school diploma; Two years previous UM experience, medical records, medical billing, or medical office experience; 2-3 years Microsoft Office programs experience; Certificate or equivalent experience in medical terminology, CPT, HCPCS, and ICD coding

Benefits

Excellent medical, vision, and dental coverage; 401k savings plan with a company match; Flexible time off and 9 Paid Holidays; Eligible for annual bonus program