Position

Coordinator- Integrated Transitional Care

Description

Under the general direction of the Manager, UM Regulatory & Compliance - CCA the Coordinator - Utilization Management Outpatient - CCA, is a high paced position that requires timely processing of authorization requests, verifying eligibility and obtaining additional information as requested by Medical Management or Utilization Management Nurses.

This position requires that one be organized, ability to multitask with a working knowledge of , CPT Coding and Medical Terminology.

The coordinator - Utilization Management Outpatient - CCA also ensures that provider calls are responded to in an accurate and timely manner while always maintaining highest level of customer service.

Commitment to Quality : The Team is committed to incorporating Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Requirements

• Minimum of three () years of experience as a data entry specialist or coordinator
• Experience with Commercial Plan Coverage required
• Requires knowledge of ICD- / and CPT codes
• Managed Care or physician office a must
• Knowledge of Commercial Managed Care coverage required
• Skilled in computer applications, including word processing, database, and spreadsheets

Additional information

Hybrid work schedule

Mon. / Fri. work from home, Tues. / Wed. / Thurs. work in office

INDH