UM Coordinator

  • Full Time
  • Pasadena

Website Imperial Management Administrators Services Imperial Management Administrators Services

Imperial Management Administrators Services

This position processes authorizations and ensures that all information is correct before submitting for approval. All authorizations should be entered within a timely manner with complete data, as well as, all the documents that will support medical necessity. The UM Coordinator will need to have strong written/communication skills in order to provide Medical Director, providers, and members necessary information to ensure the delivery of high-quality effective healthcare.

Duties & Responsibilities include but not limited:

• Open and process UM incoming faxes periodically throughout the business day

• Answer phones: Providing customer service to calls from providers and/or members

• Print approvals and modification letters from the database on a daily basis

• Scan any faxes to existing authorizations in the system

• Route medical reviewer’s cases to appropriate personnel in timely manner on a daily basis

• Verify duplicate requests and call/notify doctor’s office of referral request cancellations

• Contact and follow up with providers on pending clinical/documents within the turnaround time. (Routine 5 days, Urgent 72 hours)

• Verify and update all missing information (DOS, POS, outpatient or inpatient) before submitting for approval

• Must have experience in making outgoing phone calls as well as taking incoming phone inquiries

**Perform additional UM functions as required by the department

Skills/Abilities

• Demonstrate proficiency in 10 key and computer use.

• Excellent communication

• Detail oriented

• Self-motivated

• Work effectively in a fast pace work environment

• Strong organizational and task prioritization

• Establish the ability to multitask and adjust to the workload

• Strong work ethic

• Provide positive attitude

Education:

High School Diploma

1 year of experience REQUIRED

To apply for this job please visit forms.office.com.