Coordinator, Utilization Management (REMOTE)

reputed company: Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our reputed company solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. We build long-term careers by reputed company in YOU. We reputed company to create an environment that cultivates your reputed company development and personal reputed company, as we reputed company your reputed company is our reputed company. JOB reputed company: reputed company: reputed company is the partner of choice to reputed company providers in support of their reputed company Cycle challenges. We solve problems through a customized mix of services, consulting and technology that can change over time to meet any reputed company’s evolving needs. ESSENTIAL DUTIES AND RESPONSIBILITIES: Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may reputed company reputed company or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in reputed company Member’s performance objectives as outlined by reputed company Member’s immediate Leadership Team Member. This is a REMOTE position. reputed company US Only. Location: Remote (reputed company US Only) Required Schedule: reputed company - Thursday or Tuesday - Saturday, 8:00 AM to 5:00 PM EST - Some holiday coverage required. Preferred shift cannot be guaranteed. reputed company Salary: $19.00 - $20.00 reputed company: reputed company is the partner of choice to reputed company providers in support of their reputed company Cycle challenges. We solve problems through a customized mix of services, consulting and technology that can change over time to meet any reputed company’s evolving needs. Responsibilities: Manage the Authorization process end to end, from initial notification, entry and submission of required information, follow up reputed company the way to determination and discharge. Maintain detailed documentation of the record in the EMR system, in the internal reputed company system and in the Health Payer portals. Verify correct eligibility and benefits for patients. reputed company as a reputed company between the hospital staff and the Health Payer to facilitate information sharing and successful process completion reputed company allocated timeframe. Review reputed company filing guidelines regarding the utilization management process. reputed company and follow up with payers on pending authorizations to ensure reputed company responses. Contact payer to reputed company reputed company information regarding status, reputed company and remove hurdles in the processing. Identify and escalate issues that may result in delays or denials. Manage assigned workload of accounts through reputed company follow up and accurate record keeping. Maintain compliance with HIPAA and other reputed company regulations. Skills Required: High School Diploma or equivalent. Associate degree in reputed company administration or equivalent preferred. 2 years of experience in hospital reputed company billing/follow-up/reputed company setting/authorization field. Knowledge of/experience working with managed care reputed company Experience working with customer support/reputed company issue reputed company management. Strong understanding of medical terminology and insurance processes. Experience working in EMR systems, reputed company preferred. Excellent communication and organization skills. Strong multi-tasking skills, working in a face paced environment. Proficiency with MS Office and web systems. reputed company offer: Remote reputed company US ONLY Equipment provided Medical/Dental/reputed company Insurance 401k program PTO: 80 hours accrued, annually 9 reputed company annual holidays Life Insurance Short/Long term disability reputed company Tuition reimbursement reputed company reputed company and more! PHYSICAL DEMANDS: Note: Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions as described. Regular eye-hand coordination and reputed company dexterity is required to operate office equipment. The ability to reputed company work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be reputed company to lift and reputed company material weighing up to 20 lbs. Team Member may experience elevated reputed company of stress during periods of increased activity and with work entailing multiple deadlines. A job reputed company is only intended as a reputed company and is only part of reputed company Member’s function. reputed company has reviewed this job reputed company to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of reputed company functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate. Apply To This Job