UM Coordinator, Inpatient (Remote | Pacific Time Schedule)

General Duties / Responsibilities

• Assist team with daily census by entering face sheets for hospitals and skilled nursing facilities (SNF).
• Obtain medical records from hospitals and SNF’s.
• Attach medical records to authorizations.
• Enter referral requests / authorizations in system using ICD 10 and CPT coding.
• Monitor fax folders.
• Complete and document tasks as assigned by nurse.
• Maintain documentation on facilities contacted.
• Absorb and update member’s records.
• Absorb and mail/fax correspondence to facilities, related to members activities, as needed.
• Request medical records from facilities, etc., related to members activities, as needed.
• Attend case management presentations and participate, as appropriate.
• Recognize work-related problems and contribute to solutions.
• Meet specific deadlines and respond to various workloads by assigning task priorities according to department policies, standards and needs.
• Maintain confidentiality of information between and among health care professionals.
• Be a positive team player.

Job Requirements

• Inpatient concurrent review experience.
• Experience with census and admission management.
• Experience in discharge planning.
• Experience entering referrals and prior authorizations.
• Experience with Medicare Advantage.
• Experience with hospital and / or facilities backend admissions.
• Knowledge of medical terminology.
• Knowledge of ICD10 and CPT codes.
• Knowledge of Medicare, HMO, MMO, managed care plans.
• Computer proficient.
• Medical assistant experience preferred.
• Knowledge working in Access Express / Portal, Epic preferred.

Education

• Required: High school diploma or general education degree (GED).
• Preferred: Medical Terminology Certificate preferred.

Training

• Required: Proficient in Microsoft Office (Outlook, Excel, Word).
• Able to type minimum 50 words-per-minute (WPM).
• Organized and detail oriented.
• File systematically.
• Good interpersonal skills.
• Strong written, verbal, and telephonic communication skills.
• Able to read, write, and speak English fluently.

Specialized Skills

• Proficient in Microsoft Office (Outlook, Excel, Word).
• Able to type minimum 50 words-per-minute (WPM).
• Organized and detail oriented.
• File systematically.
• Good interpersonal skills.
• Strong written, verbal, and telephonic communication skills.
• Able to read, write, and speak English fluently.

Work Environment

• The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Pay Range

$41,472.00 - $62,208.00

Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.