Um Administrative Coordinator- Medicare- Wah Mon-Fri 9Am-6Pm Est

The UM Administration Coordinator contributes to administration of utilization management, performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.

Responsibilities

Where you Come In

The UM Administration Coordinator 2 provides non-clinical support for the policies and procedures ensuring best and most appropriate treatment, care or services for members. Decisions are typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.

Duties include:

• Communicate with providers to request clinical information and coordinate case dispute reviews.
• Review and attach clinical information to authorizations.
• Triage internal and external phone calls appropriately.
• Generate, proof, and send letters to members.

Required Qualifications - What it takes to Succeed

• Advanced knowledge of MS Office including Word, Excel, and Outlook in a Windows based environment and an ability to quickly learn new systems
• 1+ years administrative or customer service experience
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences
• Proven experience working with tight deadlines/timeframe in an ever changing environment
• Excellent verbal and written communication skills

Preferred Qualifications

• Proficient utilizing electronic medical record and documentation programs
• Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization
• Prior member service or customer service telephone experience desired
• Proficient and/or experience with medical terminology and/or ICD-10 codes

Additional Information

How we Value You

• Tuition Reimbursement
• Go365 perks for well-being
• Generous Paid Time Off accrual
• Benefits starting day 1 of employment
• Parent Leave
• Competitive 401k match

Work at Home Requirements

Interview Format

As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

If you are selected for a first round interview, you will receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication isn’t missed) inviting you to participate in a Modern Hire interview. In this interview, you will listen to a set of interview questions over your phone or text and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

#ThriveTogether #WorkAtHome

Scheduled Weekly Hours

40