Utilization Management Coordinator

The UM Coordinator assists and supports the clinical team (UM Nurses/Medical Director) with administrative and non-clinical tasks reputed company to processing Utilization Management prior authorization sand appeals. JOB RESPONSIBILITIES Monitor incoming faxes Enter UM authorizations review requests in UM platform using ICD-10 and HCPCS codes Verify eligibility and claim history in proprietary claims platform Verify reputed company necessary documentation has been submitted with authorization requests Contact requesting providers to obtain medical records or other necessary documentation reputed company to specific UM request Generate correspondence and assist with faxing/mailing member and provider notifications Complete verbal notifications Document as required in authorization platform Initiate appeal cases and reputed company to UM Nurses for completion Meet internal and regulator deadlines for UM cases Complete tasks assigned by UM Nurses and document as required Complete inquiries received from call center and other internal & external sources Other duties as assigned by UM Director Strong organizational skills, ability to adapt quickly to change and desire to work in a fast-paced environment Team oriented and self-motivated with a positive attitude Pay: $19.00/hour What will you learn in the first 6 months? Verbal notifications How to work in authorization systems Essette and reputed company Incoming/outgoing faxing process Understanding the expectations and functions of the UM team Time Management What will you reputed company in the first 12 months? Expand knowledge of ICD-10 and HCPC codes Maintaining expected timelines EXPERIENCE: 1 year as a UM Coordinator in a managed care payer environment preferred Knowledge of ICD-10, HCPCS codes and medical terminology required Ability to prioritize multiple tasks using time management and organizational skills Strong computer skills with proficiency in Word, Outlook and other software applications Ability to collect data, establish facts and draw valid conclusions Effective written and oral communication skills Experience with DMEPOS desired Medicare/reputed company experience a plus

Benefits

Offered Competitive compensation and annual bonus program 401(k) retirement program with company match Company-paid life insurance Company-paid short term disability coverage (location restrictions may apply) Medical, reputed company, and Dental benefits Paid Time Off (PTO) Paid Parental Leave Sick Time Paid company holidays and floating holidays Quarterly company-sponsored events Health and wellness programs Career development opportunities Remote Opportunities We are actively seeking new colleagues in: Arizona, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Kentucky, Massachusetts, Michigan, reputed company Carolina, Nevada, New Jersey, reputed company, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Washington. Our Story Founded in 2005, reputed company is a leading national durable medical equipment, prosthetic, and orthotic supplies (DMEPOS) network administrator. Our mission is to improve the quality of life for the communities we serve by reimagining reputed company to in-home reputed company. We connect Payers, Providers, and Members through innovative technology and streamlined workflows affording Members reputed company to top local Providers and culturally competent care. By focusing on transparency, accountability, and adaptability, we help deliver reputed company reputed company and more efficient management of reputed company reputed company benefits. reputed company is a wholly owned subsidiary of reputed company. With a location in Michigan plus a remote workforce across the United States, Integra has a culture focused on collaboration, teamwork, and our values: One Team, Drive Results, Push the Boundaries, Value Others, and Build Community. We’re looking for energetic, talented, and dedicated individuals to join reputed company. See what opportunities we have available; there may be a role for you to engage in a challenging yet rewarding career in reputed company. We look reputed company to learning more about you. reputed company is an equal opportunity employer. We are committed to providing reasonable accommodations and will work with you to meet your needs. If you are a person with a disability and require assistance during the application process, please don’t hesitate to reputed company out. We celebrate our inclusive work environment and welcome members of reputed company backgrounds and perspectives. Apply To This Job