[Hiring] Utilization Management Coordinator @Altais

Role Description

Are you looking to join a fast-growing, dynamic team? We’re a collaborative, purpose-driven group that’s passionate about transforming healthcare from the inside out. At Altais, we support one another, adapt quickly, and work with integrity as we build a better experience for physicians and their patients.

As a UM Coordinator, you will work closely with our Ambulatory and Concurrent Care, Network Management, Quality Improvement and Practice Success teams. Your responsibilities include:

• Driving efficient authorization processes, navigating insurance requirements with precision and advocacy.
• Responsible for all incoming authorizations, whether received via Tapestry Link portal or OnBase.
• Authorizations may require eligibility or benefit verification and data entry into Tapestry before processing and are governed by established Turn Around Times (TAT) consistent with the Industry Collaboration Effort (ICE) regulations.
• Function as the primary contact for internal and external customers requesting information or assistance related to authorizations.
• Review authorization requests per established level of review designation.
• Prepare the denial letters under the supervision of the professional staff.
• Work closely with professional staff and customer service to provide accurate technical information to provider offices and internal customers in a professional manner.
• Contact provider offices by telephone for missing clinical documentation necessary for medical review and document information requested in Tapestry.
• Cross train with all UM Coordinators to learn each process completely to ensure coverage is available.
• Ensure strict confidentiality of all health records, member information and meet HIPAA guidelines.

Qualifications

• High school diploma
• Two years previous UM experience, medical records, medical billing, or medical office experience.
• 2-3 years Microsoft Office programs experience required.
• Certificate or equivalent experience in medical terminology, CPT, HCPCS, and ICD coding required.

Requirements

• The role is a Casual, 6-month contract opportunity.

Benefits

• Excellent medical, vision, and dental coverage
• 401k savings plan with a company match
• Flexible time off and 9 Paid Holidays