UM Coordinator
Description:
The Position.The UM Coordinator position will collaborate with other UM team members, Case Managers, internal departmental heads, and medical staff to support the UM Department. Additionally, it will provide backup assistance to the UM Department and Claims Department as needed, under the direction of the Director of Claims or Director of UM. Strong written and verbal communication, organizational, clerical, and administrative skills are essential for this role, along with accurate data entry capabilities. Preferred previous experience in a call center environment is desirable but not mandatory for this role. The position will involve conducting outreach and follow-up calls to providers to ensure the receipt of all necessary information for authorizations is obtained. The Specs. Non-Exempt. In-Office. Full-Time. Benefit-Eligible:
PTO, PSL, Holidays, medical, dental, vision, etc. Schedule:
Monday - Friday. Wage Range:
$20 - $25 per hour, or depending on experience. Key Responsibilities.o Assists UM Department (90-95%) and Claims Department (5-10%), on as needed basis, or as instructed by the Director of UM or Director of Claims.o Request and follow up for supporting documentation and clinical notes from physicians, , health plans, hospitals, and other healthcare entities.o Monitoring of emails and faxes on a daily basis, and appropriately distributes incoming faxes.o Verify all data, member, and provider information before processing referrals and authorizations.o Prepare, print, and mail member and/or claims notifications.o Monitors the Turn-Around Timeframes (TAT).o Manage the daily workload and prioritizing according to TAT and managing daily workload according to TAT.o Troubleshoot incoming calls from members, providers, health plans, insurance brokers, collection agents and hospitals.o Research and resolve authorizations, eligibility inquiries and any additional concerns.o Conduct member, provider, billing outreach communications via mail, e-mail, and/or telephone/fax.o Enter data and process authorizations and claims requests with the appropriate coding and quantities.o Assist in mail room, scanning and inputting data in accordance with department practice in Company software.o Communicate effectively in a professional and respectful manner internally and externally.o Always maintain strictest confidentiality according to company Confidentiality Agreement and federal and state laws and regulations, such as HIPAA.o Must be ethical and possess the ability to remain impartial and objective.o Active participation in existing training to ensure consistency and quality.o Knowledge of QuickCap and additional programs (MCG, VAE).o Performs other clerical duties, projects, and actions as assigned accordingly in UM and Claims Department.Entering data and processing referral authorization requests with the appropriate coding and quantitieso Handling UM Department's mailing distribution and assisting in mail room, which may require scanning and inputting data in accordance with department practiceo Research and resolve authorizations, eligibility inquiries and any additional concernso Processing authorizations as needed and claims request with appropriate coding and quantitieso Other duties as assigned.IMS offers competitive compensation depending on experience. We are an equal opportunity employer and seek diversity in our workforce. IMS is also an E-Verify Employer. To learn more about E-Verify and your rights and responsibilities, please visit:
https:
//www.e-verify.gov/employees/employee-rights-and-responsibilities .Requirements:
The Education.High School diploma or general education degree (GED) or higher degree preferred.The Experience. Minimum of 2 years' experience in a health plan, IPA/medical group, or MSO in customer service/member services or call center capacity to include management of staff. ICD-10 and CPT coding experience. The Skills, Knowledge, Abilities, and Other Attributes. 1-2 years' experience in a health plan, IPA, or MSO, preferably in UM Department, preferred ICD-10 and CPT coding experienceable to sit for 6 hours or longer in an office environment Ability to prioritize, organize, and multi-task in a fast-paced, changing environment Excellent Customer Service and telephone etiquette Strong interpersonal communication skills Proficient in Microsoft Office applications Ability to work independently and in a team Highly efficient and able to adapt quickly to learning internal software systems, QuickCap Preferred Ability to prioritize, organize, and multi-task in a fast paced, changing environment while meeting deadlines and TAT requirements. Accurate data-entry and administration abilities. Strong technical and computer skills. Quick learner and ability to easily learning new databases. Pro-active abilities and self-starter attitude. Ability to adapt to changes in operations quickly. Healthcare knowledge of HIPAA regulations and other privacy and security guidelines related to handling sensitive claims data and PHI. Strong analytical and problem-solving skills, with the ability to identify patterns, trends, and areas for process improvement. Ability to work in a fast-paced, deadline-driven environment while maintaining a high level of accuracy and attention to detail. Please note that the duties and responsibilities outlined above are summarized and may not encompass all tasks associated with the position. The nature of the role may require adaptation to changing circumstances and additional responsibilities not explicitly mentioned here. The organization reserves the right to modify, interpret, or supplement the job duties as needed. Compensation details:
20-25 Hourly WagePI4eda75b2d740-25448-29622008 Recommended Skills Adaptability Attention To Detail Billing Business Process Improvement Call Centers Claim Processing Apply to this job. Think you're the perfect candidate? Apply on company site $('.external-apply-email-saved').on('click', function (event) window.ExternalApply = window.open('/interstitial?jobdid=j3t72t6ygfpw2mhs7f8', 'ExternalApply-j3t72t6ygfpw2mhs7f8'); ); $(document).ready( function() $(#ads-desktop-placeholder).html(
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n Estimated Salary: $20 to $28 per hour based on qualifications.
The Position.The UM Coordinator position will collaborate with other UM team members, Case Managers, internal departmental heads, and medical staff to support the UM Department. Additionally, it will provide backup assistance to the UM Department and Claims Department as needed, under the direction of the Director of Claims or Director of UM. Strong written and verbal communication, organizational, clerical, and administrative skills are essential for this role, along with accurate data entry capabilities. Preferred previous experience in a call center environment is desirable but not mandatory for this role. The position will involve conducting outreach and follow-up calls to providers to ensure the receipt of all necessary information for authorizations is obtained. The Specs. Non-Exempt. In-Office. Full-Time. Benefit-Eligible:
PTO, PSL, Holidays, medical, dental, vision, etc. Schedule:
Monday - Friday. Wage Range:
$20 - $25 per hour, or depending on experience. Key Responsibilities.o Assists UM Department (90-95%) and Claims Department (5-10%), on as needed basis, or as instructed by the Director of UM or Director of Claims.o Request and follow up for supporting documentation and clinical notes from physicians, , health plans, hospitals, and other healthcare entities.o Monitoring of emails and faxes on a daily basis, and appropriately distributes incoming faxes.o Verify all data, member, and provider information before processing referrals and authorizations.o Prepare, print, and mail member and/or claims notifications.o Monitors the Turn-Around Timeframes (TAT).o Manage the daily workload and prioritizing according to TAT and managing daily workload according to TAT.o Troubleshoot incoming calls from members, providers, health plans, insurance brokers, collection agents and hospitals.o Research and resolve authorizations, eligibility inquiries and any additional concerns.o Conduct member, provider, billing outreach communications via mail, e-mail, and/or telephone/fax.o Enter data and process authorizations and claims requests with the appropriate coding and quantities.o Assist in mail room, scanning and inputting data in accordance with department practice in Company software.o Communicate effectively in a professional and respectful manner internally and externally.o Always maintain strictest confidentiality according to company Confidentiality Agreement and federal and state laws and regulations, such as HIPAA.o Must be ethical and possess the ability to remain impartial and objective.o Active participation in existing training to ensure consistency and quality.o Knowledge of QuickCap and additional programs (MCG, VAE).o Performs other clerical duties, projects, and actions as assigned accordingly in UM and Claims Department.Entering data and processing referral authorization requests with the appropriate coding and quantitieso Handling UM Department's mailing distribution and assisting in mail room, which may require scanning and inputting data in accordance with department practiceo Research and resolve authorizations, eligibility inquiries and any additional concernso Processing authorizations as needed and claims request with appropriate coding and quantitieso Other duties as assigned.IMS offers competitive compensation depending on experience. We are an equal opportunity employer and seek diversity in our workforce. IMS is also an E-Verify Employer. To learn more about E-Verify and your rights and responsibilities, please visit:
https:
//www.e-verify.gov/employees/employee-rights-and-responsibilities .Requirements:
The Education.High School diploma or general education degree (GED) or higher degree preferred.The Experience. Minimum of 2 years' experience in a health plan, IPA/medical group, or MSO in customer service/member services or call center capacity to include management of staff. ICD-10 and CPT coding experience. The Skills, Knowledge, Abilities, and Other Attributes. 1-2 years' experience in a health plan, IPA, or MSO, preferably in UM Department, preferred ICD-10 and CPT coding experienceable to sit for 6 hours or longer in an office environment Ability to prioritize, organize, and multi-task in a fast-paced, changing environment Excellent Customer Service and telephone etiquette Strong interpersonal communication skills Proficient in Microsoft Office applications Ability to work independently and in a team Highly efficient and able to adapt quickly to learning internal software systems, QuickCap Preferred Ability to prioritize, organize, and multi-task in a fast paced, changing environment while meeting deadlines and TAT requirements. Accurate data-entry and administration abilities. Strong technical and computer skills. Quick learner and ability to easily learning new databases. Pro-active abilities and self-starter attitude. Ability to adapt to changes in operations quickly. Healthcare knowledge of HIPAA regulations and other privacy and security guidelines related to handling sensitive claims data and PHI. Strong analytical and problem-solving skills, with the ability to identify patterns, trends, and areas for process improvement. Ability to work in a fast-paced, deadline-driven environment while maintaining a high level of accuracy and attention to detail. Please note that the duties and responsibilities outlined above are summarized and may not encompass all tasks associated with the position. The nature of the role may require adaptation to changing circumstances and additional responsibilities not explicitly mentioned here. The organization reserves the right to modify, interpret, or supplement the job duties as needed. Compensation details:
20-25 Hourly WagePI4eda75b2d740-25448-29622008 Recommended Skills Adaptability Attention To Detail Billing Business Process Improvement Call Centers Claim Processing Apply to this job. Think you're the perfect candidate? Apply on company site $('.external-apply-email-saved').on('click', function (event) window.ExternalApply = window.open('/interstitial?jobdid=j3t72t6ygfpw2mhs7f8', 'ExternalApply-j3t72t6ygfpw2mhs7f8'); ); $(document).ready( function() $(#ads-desktop-placeholder).html(
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n Estimated Salary: $20 to $28 per hour based on qualifications.
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