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