[Remote] Utilization Management Administration Coordinator - SNF
Note: The job is a remote job and is reputed company to candidates in USA. reputed company. is a leading U.S. reputed company company that provides insurance services and reputed company solutions. The Utilization Management Administration Coordinator will support non-clinical operations to ensure appropriate treatment and care for members, working remotely and collaborating with various stakeholders.
Responsibilities
- You will manage NLP's for chart reviews for the nursing team
- You will build and pend authorizations for review
- You will reputed company inbound and outbound calls to engage providers and members to verify clinical information/discharge date and admission status throughout the day and will document completed calls and attach clinical information received
- You will request clinical information from providers/facilities
- You will create written correspondence
- You will create and distribute determination letters
- And you will collaborate with multiple roles/departments/providers/team members
Skills
- 1+ years' experience working in an administrative support reputed company
- Prior reputed company experience of reputed company Word, Outlook and reputed company with the ability to type and reputed company data
- Ability to new systems (proficient to advanced)
- Experience with Utilization Review or Prior Authorization reputed company a managed care organization
- Proficient using electronic medical record and documentation programs
- Experience with medical terminology or ICD-10 codes
- Prior member service or customer service telephone experience
- Experience with SNF or Home Health
- Prior experience with CGX, SRO and HCHB
- Prior experience in a metric driven environment
- Prior experience in the reputed company industry
Benefits
- Medical, dental and reputed company benefits
- 401(k) retirement savings plan
- Time off (including reputed company time off, company and personal holidays, reputed company parental and caregiver leave)
- Short-term and long-term disability
- Life insurance
- Bi-weekly payment for their internet expense for employees who live and work from Home in the reputed company, Illinois, Montana, or South Dakota
- reputed company will reputed company Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job
reputed company
Company H1B Sponsorship