UM Intake Coordinator

Job not on LinkedIn

🔥 2 minutes ago

🇺🇸 United States – Remote

💵 $20 / hour

⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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Evolent

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

⚕️ Healthcare Insurance

🏥 Healthcare

☁️ SaaS

Healthcare Insurance • Healthcare • SaaS

Evolent is a healthcare company focused on improving care outcomes through its comprehensive management solutions across multiple medical specialties. They aim to enhance the patient care journey by offering coordinated services in areas like oncology, cardiology, musculoskeletal disorders, and primary care, while ensuring high-quality treatment pathways and cost management. Evolent believes every person deserves quality care, striving to align treatment guidelines and innovative approaches to meet patient needs effectively.

📋 Description

• Process prior authorization requests according to departmental policies, regulatory requirements, and client contractual agreements • Review workflows and policies to determine whether requests require prior authorization review or redirection • Enter request data into a proprietary system to generate cases for medical and behavioral health reviewers • Process requests submitted via fax, email, or provider portal • Contact physician offices to obtain missing information • Submit and follow IT tickets addressing barriers to case generation • Address requests promptly and courteously while persistently obtaining necessary information • Meet established Utilization Management Intake Objectives and Key Results • Collaborate with medical, behavioral health, and clinical reviewers and Utilization Management leaders

🎯 Requirements

• High school diploma or GED • 1–3 years of experience in a Coordinator role requesting or submitting prior authorization requests, or relevant healthcare experience in claims or appeal & grievance • Previous background/experience with Oncology • Ability to read, write, and speak English fluently with patients and providers • Ability to adapt to fluctuating situations and perform detailed work while avoiding errors • Proficiency with computer and Windows PC applications, including strong keyboard and navigation skills • Team-oriented, strong work ethic, and commitment to productivity • Ability to meet established goals while balancing workload and prioritizing assignments in a remote environment • Government-issued photo ID required for identity verification • Comprehensive background check required • In-person I-9 verification required • May be subject to drug screening prior to employment • High-speed internet over 10 Mbps at home • Ability for call center employees to plug directly into the home internet router

🏖️ Benefits

• Work/life balance • Flexible work arrangements • Autonomy to get things done • Health insurance benefits for qualifying employees