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UM Coordinator

Company: Innovative Management Systems Incorporated
Location: Whittier
Posted on: August 6, 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 quantities
  • Monitoring of emails and faxes on a daily basis, and appropriately distributes incoming faxes
  • Verifies all member and provider data and information before processing referrals and authorizations
  • Monitors the Turn-Around Timeframes (TAT) and managing daily workload according to TAT
  • Troubleshooting calls from members, providers, health plans, hospitals and other business affiliates in order for members to be seen for healthcare services
  • Handling UM Department's mailing distribution and assisting in mail room, which may require scanning and inputting data in accordance with department practice
  • Research and resolve authorizations, eligibility inquiries and any additional concerns
  • Processing authorizations as needed and claims request with appropriate coding and quantities Requirements:
    • 1-2 years' experience in a health plan, IPA, or MSO, preferably in UM Department, preferred
    • ICD-10 and CPT coding experienceable to sit for 6 hours or longer in an office environment
    • Sensory requirements: talk, hear, see
    • Ability to prioritize, organize, and multi-task in a fast-paced, changing environment
    • Excellent Customer Service and telephone etiquette
    • Good interpersonal communication skills
    • Proficient in Microsoft Office applications
    • Ability to work independently and in a team
    • Highly efficient and able to adapt quickly to learning internal software systems, QuickCap Preferred
    • High School Diploma or GED, or higher degree preferred
    • Bi-/Multi-Lingual is a preferred (Korean, Mandarin/Cantonese is a plus)


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

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