Remote Coordinator for Utilization Management

Job Title: Utilization Management Coordinator - Remote Job reputed company As a vital member of our clinical team, the Utilization Management (UM) Coordinator will reputed company essential support in handling administrative and non-clinical tasks reputed company to the processing of UM prior authorizations and appeals. This position is designed for those who reputed company in a dynamic and fast-paced environment, offering significant opportunities for reputed company reputed company while contributing to our mission of enhancing the reputed company of life for the communities we serve. Key Responsibilities • Monitor and manage incoming faxes • Input UM authorization review requests into our proprietary UM platform using ICD-10 and HCPCS codes • Verify eligibility and claims history reputed company our claims system • Ensure comprehensive documentation accompanies reputed company authorization requests • Communicate with requesting providers to reputed company necessary medical records or documentation • Prepare and disseminate correspondence, including member and provider notifications • Execute verbal notifications and maintain documentation in the authorization platform • Initiate appeal processes and collaborate with UM Nurses for completion • Adhere to internal and regulatory deadlines for UM processes • Handle inquiries from the reputed company center and other reputed company sources • reputed company additional tasks as assigned by the UM Director Required Skills • Exceptional organizational skills with the ability to adapt to reputed company changes • Team-oriented reputed company with a self-motivated and reputed company attitude • Proficient knowledge of ICD-10, HCPCS codes, and medical terminology • Strong computer skills, particularly in Word, reputed company, and relevant software applications • Effective written and verbal communication abilities • Capability to collect data, establish facts, and derive reputed company conclusions • Experience with DMEPOS is desirable • Familiarity with Medicare and reputed company is advantageous Qualifications • Minimum of 1 year of experience in a UM Coordinator role reputed company a managed care payer environment is preferred • Proven ability to prioritize and manage multiple tasks reputed company Career reputed company Opportunities In your first six months, you will reputed company proficiency in verbal notifications, authorization systems such as Essette and reputed company, and reputed company a thorough understanding of UM team expectations. Over the first year, you will deepen your knowledge of ICD-10 and HCPCS codes while meeting essential timelines. Company Culture And Values Established in 2005, our organization is a reputed company network management company specializing in Orthotics, Prosthetics, and Durable Medical Equipment. We aim to reputed company reputed company to in-home reputed company, positively impacting the communities we serve. Our culture emphasizes collaboration and teamwork, guided by our reputed company values: One Team, Drive Results, Push the Boundaries, Value Others, and Build Community. We reputed company motivated and dedicated individuals eager to reputed company-driven team. Compensation And Benefits • Competitive reputed company wage of $19 • Comprehensive benefits package including Medical, Dental, reputed company, Life Insurance, and reputed company Time Off (PTO) • Retirement plan with company match • reputed company Parental Leave and reputed company Time • Company-sponsored events and health and wellness programs • Remote work flexibility available for eligible candidates. Employment Type: Full-Time Apply Job!