The Coordinator, UM Intake provides administrative support to the Utilization Management team by ensuring the efficient intake, review, and processing of documents. This role helps support daily operations across UM intake, prior authorization, and clinical review workflows.
Work schedule: 9:30 am - 6:00 pm Pacific Time, with rotating weekends.
Key responsibilities:
- Prepare inbound faxes for processing, including reviewing content and editing labels for accurate document classification
- Review service level agreement grids to determine turnaround timeframes and accurately document TAT
- Monitor the failed fax dashboard and coordinate re-sending of correspondence through appropriate channels
- Respond to shared inbox requests by retrieving requested clinical documents and attaching them for case review
- Assist with additional administrative tasks as needed
- Meet established UM Intake objectives and key results
Requirements & Qualifications
A high school diploma or GED is required.
Required qualifications:
- 1 to 3 years of experience in population management, managed care, insurance, or a hospital medical management department
- Basic knowledge of medical records and the ability to locate and verify member details
- Familiarity with health insurance lines of business, including Commercial, Medicare, and Medicaid
- Working knowledge of medical coding systems, including CPT/HCPCS, to differentiate between medical and pharmacy prior authorization requests
- Ability to adapt to changing situations and perform detailed work while avoiding errors
- Proficiency with Outlook, Word, Excel, and OneNote in a Windows PC environment
- Strong keyboard and navigation skills
- Team-oriented with a strong work ethic and focus on productivity
Preferred qualifications:
- Ability to meet goals while balancing workload and prioritizing assignments in a remote environment
Benefits & Perks
Comprehensive benefits package, including health insurance, offered to qualifying employees.
Location
N/A
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
Yes
Posted
1 month ago