Prior Authorization UM Administration Coordinator

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Requirements:

• 1 or more years of experience with Utilization Review and/or Prior Authorization
• 1 or more years of Healthcare experience
• Working knowledge of Microsoft Word, Excel, and Outlook.
• Live in CST or EST states

Responsibilities:

• Support the UM Nurses to process discharge orders and arrange a safe facility discharge.
• Work with UM Nurses, Pharmacy, Medical Directors and other Departments.
• Make calls to UM Nurses, Hospitals, Skilled Nursing Facilities and other vendors.
• Document all calls and requests.
• Search for Medicare and Medicaid Guidelines.
• Process all incoming fax/emails request for services the same day.
• Return call for all voice messages received the same day.
• Process provider and member letters (Letter of Agreements, Approvals, Denials etc.)
• Mail letters to members.
• Assist the team with various clerical/administrative tasks as necessary.
• Participate in special projects as assigned by your Supervisor or Manager.