The Utilization Management Coordinator will assist in the process of CHC Providers obtaining authorization, ensuring accurate data entry in the Utilization Module, and assist with requested services/treatments that do not require clinical decision making. Handles entry of all notifications of admission, transfers, and assist with the data entry of requests for home health, and durable medical equipment. They will use analytical and professional skills to answer phone calls and screen documents for key information necessary for clinical staff and Medical Directors. This will assist them in making informed medical decisions regarding admissions, transfers, services and transports. They will also support regulatory timelines and CHC guidelines.
- Hign school diploma. College Education, preferred
- Three - five years experience in Referrals/Authorizations.
- One year insurance related experience in a managed care environment.
- Experience in Medical coding preferred
- Microsoft Word, Excel and Outlook experience preferred.
- Strong verbal and written communication skills
- Writing /Composing (Correspondence/Reports)
- Analytical, Medical Terms, MS Word, MS Excel
- Able to work independently under general instructions and have reliable transportation