UM Coordinator

Company: Innovative Management Systems Incorporated
Location: Whittier
Posted on: August 4, 2022

Job Description:

Description:Position: UM CoordinatorFLSA: Non-ExemptBenefit-Eligible, PTO, PSL, some Holidays off, work-life balanceDepartment: Utilization Management (UM)Schedule: Mon - Fri.In-officeSalary: starting $20-24 or competitive compensation per experienceThis position works collaboratively with the Case Managers, Claims Department, and Medical Management staff and supports UM Department. This position requires strong written and communication skills and the ability to interact with Medical Director, healthcare providers, IPAs, and members to ensure the delivery of high-quality, cost effective healthcare.Some Major duties include:Entering data and processing referral authorization requests with the appropriate coding and quantitiesMonitoring of emails and faxes on a daily basis, and appropriately distributes incoming faxesVerifies all member and provider data and information before processing referrals and authorizationsMonitors the Turn-Around Timeframes (TAT) and managing daily workload according to TATTroubleshooting calls from members, providers, health plans, hospitals and other business affiliates in order for members to be seen for healthcare servicesHandling UM Department's mailing distribution and assisting in mail room, which may require scanning and inputting data in accordance with department practiceResearch and resolve authorizations, eligibility inquiries and any additional concernsProcessing authorizations as needed and claims request with appropriate coding and quantitiesRequirements:1-2 years' experience in a health plan, IPA, or MSO, preferably in UM Department, preferredICD-10 and CPT coding experienceable to sit for 6 hours or longer in an office environmentSensory requirements: talk, hear, seeAbility to prioritize, organize, and multi-task in a fast-paced, changing environmentExcellent Customer Service and telephone etiquetteGood interpersonal communication skillsProficient in Microsoft Office applicationsAbility to work independently and in a teamHighly efficient and able to adapt quickly to learning internal software systems, QuickCap PreferredHigh School Diploma or GED, or higher degree preferredBi-/Multi-Lingual is a preferred (Korean, Mandarin/Cantonese is a plus)PI185630708SDL2017

Keywords: Innovative Management Systems Incorporated, Whittier , UM Coordinator, Other , Whittier, California