Utilization Management Coordinator

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 10%

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CorroHealth

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

🏥 Healthcare

⚕️ Healthcare Insurance

☁️ SaaS

Healthcare • Healthcare Insurance • SaaS

CorroHealth is a leading provider of clinically led healthcare analytics and technology-driven solutions, focused on enhancing the financial performance of hospitals and health systems. Their integrated solutions and advanced technologies aim to optimize the entire revenue cycle, offering services such as revenue cycle management, clinical documentation, medical coding, and denials management. With a commitment to improving financial health through intelligent technology and expert guidance, CorroHealth addresses complex payer-provider relationships and supports efficient healthcare operations.

📋 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

🎯 Requirements

• 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

🏖️ 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!