[Hiring] Coordinator, Utilization Management @CorroHealth

Role Description

Manage the Authorization process end to end, from initial notification, entry and submission of required information, follow up all the way to determination and discharge.

• Maintain detailed documentation of the record in the EMR system, in the internal CorroHealth system and in the Health Payer portals.
• Verify correct eligibility and benefits for patients.
• Act as a liaison between the hospital staff and the Health Payer to facilitate information sharing and successful process completion within allocated timeframe.
• Review timely filing guidelines regarding the utilization management process.
• Track and follow up with payers on pending authorizations to ensure timely responses.
• Contact payer to elicit further information regarding status, decisions and remove hurdles in the processing.
• Identify and escalate issues that may result in delays or denials.
• Manage assigned workload of accounts through timely follow up and accurate record keeping.
• Maintain compliance with HIPAA and other healthcare regulations.

Qualifications

• High School Diploma or equivalent. Associate degree in healthcare administration or equivalent preferred.
• 2 years of experience in hospital related billing/follow-up/healthcare setting/authorization field.
• Knowledge of/experience working with managed care contracts.
• Experience working with customer support/client issue resolution management.
• Strong understanding of medical terminology and insurance processes.
• Experience working in EMR systems, Epic preferred.
• Excellent communication and organization skills.
• Strong multi-tasking skills, working in a fast-paced environment.
• Proficiency with MS Office and web systems.

Requirements

• This is a remote position.
• Location: Remote (Within US Only)
• Required Schedule: Full-time shifts from 8:00 AM to 5:00 PM EST either Sunday - Thursday or Tuesday - Saturday.
• Hourly Salary: $19.00 - $20.00.
• Some holiday coverage is required.

Benefits

• Remote within US ONLY.
• Equipment provided.
• Medical/Dental/Vision Insurance.
• 401k matching (up to 2%).
• PTO: 80 hours accrued, annually.
• 9 paid annual holidays.
• Life Insurance.
• Short/Long term disability options.
• Tuition reimbursement.
• Professional growth and more!

Physical Demands

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform 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 able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines.