Utilization Management Coordinator

Emploi pas sur LinkedIn

🕒 il y a 19 jours

🇺🇸 États-Unis – Télétravail

⏰ Temps Plein

🟢 Junior

🟡 Intermédiaire

🚫👨‍🎓 Aucun diplôme requis

🦅 Parrain de Visa H1B

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👻 Score fantôme 10%

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🗣️🇺🇸🇬🇧 Anglais requis

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CorroHealth

5001 - 10000 employés

🏥 Santé

⚕️ Assurance santé

☁️ SaaS

Healthcare • Healthcare Insurance • SaaS

CorroHealth est un fournisseur de premier plan en matière d'analytique de santé dirigée cliniquement et de solutions technologiques, axé sur l'amélioration de la performance financière des hôpitaux et des systèmes de santé. Leurs solutions intégrées et technologies avancées visent à optimiser l'ensemble du cycle de revenus, en offrant des services tels que la gestion du cycle de revenus, la documentation clinique, le codage médical et la gestion des refus. Avec un engagement à améliorer la santé financière à travers une technologie intelligente et des conseils d'experts, CorroHealth aborde les relations complexes entre payeurs et prestataires et soutient des opérations de santé efficaces.

Description

• Manage the authorization process end to end, from initial notification, entry and submission of required information through follow-up, determination, and discharge • Maintain detailed documentation in the EMR system, internal CorroHealth system, and Health Payer portals • Verify correct eligibility and benefits for patients • Act as a liaison between hospital staff and Health Payers to facilitate information sharing and successful process completion within allocated timeframes • Review timely filing guidelines regarding the utilization management process • Track and follow up with payers on pending authorizations to ensure timely responses • Contact payers to obtain further information regarding status and decisions and remove processing hurdles • 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

🎯 Exigences

• 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 face paced environment • Proficiency with MS Office and web systems • Required schedule: Tuesday - Saturday, 8:00 AM to 5:00 PM EST • Some holiday coverage required • Ability to perform work at a computer terminal for 6-8 hours a day • Infrequent ability to lift and move material weighing up to 20 lbs

🏖️ Avantages

• 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!

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