Utilization Management Coordinator - Casual
$52,000–$62,400 year
RemoteUnited States
United StatesRemoteFull Time$52,000–$62,400 yearHigh School Or EquivalentSmall
Full TimeHigh School Or EquivalentSmall
Job Summary
Manage all incoming authorizations via Tapestry Link or OnBase, performing eligibility and benefit verification before processing in strict adherence to Turn Around Times. Function as the primary contact for internal and external inquiries, reviewing requests per designated levels and preparing denial letters under supervision. Contact provider offices by telephone to obtain missing clinical documentation and cross-train with other UM Coordinators to ensure full process coverage. Maintain strict confidentiality of all health records and member information in compliance with HIPAA guidelines.
Required Qualifications
- High school diploma
- Two years previous UM experience, medical records, medical billing, or medical office experience
- 2-3 years Microsoft Office programs experience required
- Certificate or equivalent experience in medical terminology, CPT, HCPCS, and ICD coding required
- External hires must pass a background check/drug screen
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