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Utilization Management (UM) Coordinator Job

Eingestellt von Yoh

Gesuchte Skills: Client

Projektbeschreibung

UTILIZATION MANAGEMENT (UM) COORDINATOR needed for a CONTRACT opportunity with Yoh's client located in Richmond, CA.

Top Skills Should You Possess:
- Managed care coordination
- Prior Authorization Office experience

What You'll Be Doing:
- Processing inpatient and outpatient provider authorization requests
- Confirming member eligibility and benefit availability while focusing on the use of preferred providers
- Completing approvals with required documentation within regulatory timeframes
- Notify members and providers of determinations per requirements

What You Need to Bring to the Table:
- BA/BS Degree in related field preferred
- Two (2) plus years of experience in a managed care environment
- Experience utilizing managed care systems, regulations, CPT, ICD-9 and HCPCS codes
- Knowledge of ancillary and hospital based services and contracts
- Knowledge of healthcare claims processes, capitation, healthcare operations
- Experience with Microsoft Office
- Medical Assistant certification or IPA or Health Plan Experience preferred

OPPORTUNITY IS CALLING, APPLY NOW!

RECRUITER: Emi Flaherty

Yoh, a Day & Zimmermann company, is an Equal Opportunity Employer, M/F/D/V. Click here to contact us if you are an individual with a disability and require accommodation in the application process.

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Ref:

SFSF: HC

Projektdetails

  • Vertragsart:

    Contract

  • Berufserfahrung:

    Keine Angabe

Geforderte Qualifikationen

  • Kategorie:

    IT Entwicklung

  • Skills:

    client

Yoh