UM Coordinator – Inpatient

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Alignment Health

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2013

⚕️ Healthcare Insurance

💰 $135M Series C on 2020-03

Healthcare Insurance • Insurance • Healthcare

Alignment Health is dedicated to providing comprehensive care for Medicare members, emphasizing the needs of seniors, the chronically ill, and those who are frail. With a mission to transform senior healthcare, Alignment Health leverages a tailored care model and advanced technology to deliver high-quality, low-cost healthcare services. Their 24/7 concierge care team collaborates with trusted local providers to ensure that every member receives personalized care, reflecting the company's commitment to treating all members as valued family members.

📋 Description

• Assist team with daily census by entering face sheets for hospitals and skilled nursing facilities (SNF). • Obtain medical records from hospitals and SNF’s. • Attach medical records to authorizations. • Enter referral requests / authorizations in system using ICD 10 and CPT coding. • Monitor fax folders. • Complete and document tasks as assigned by nurse. • Maintain documentation on facilities contacted. • Assist with maintaining and updating member’s records. • Assist with mailing or faxing correspondence to facilities, related to, as needed. • Request medical records from facilities, etc., related to members activities, as needed. • Attend case management presentations and participates, as appropriate. • Recognize work-related problems and contributes to solutions. • Meet specific deadlines and respond to various workloads by assigning task priorities according to department policies, standards and needs. • Maintain confidentiality of information between and among health care professionals. • Be a positive team player.

🎯 Requirements

• Inpatient concurrent review experience • Experience with census and admission management • Experience in discharge planning • Experience entering referrals and prior authorizations. • Experience with Medicare Advantage • Experience with hospital and / or facilities backend admissions • Knowledge of medical terminology • Knowledge of ICD10 and CPT codes • Knowledge of Medicare, HMO, MMO, managed care plans • Computer proficient • Medical assistant experience preferred • Knowledge working in Access Express / Portal, Epic preferred.