UM COORDINATOR

MEADVILLE MEDICAL CENTER; Meadville (Crawford County); On-site; USD 32,000 - 46,000; Full time

Job summary

Liberty Street Hospital in Meadville, PA is seeking an organized office specialist to support the Utilization Management team. You will review accounts, verify authorizations, communicate with insurance companies, and maintain accurate logs and department spreadsheets.

The role requires attentiveness to HIPAA regulations, strong multitasking, and the ability to prepare reports and assist with presentations and supply orders.

Qualifications

• Demonstrates knowledge of organizational policies regarding insurance appeals.
• Reviews accounts and communicates with insurance companies to get appeal determinations.
• Maintains strict HIPAA confidentiality and regulatory compliance.
• Notifies administrative personnel of important situations or problems.

Responsibilities

• Reviews accounts to see if payment has been received and keep documentation log.
• Communicates with insurance companies to obtain appeal determinations.
• Responds to telephone calls and messages from patients, insurance companies and staff courteously and promptly.
• Creates and maintains department spreadsheets.
• Verify surgical pre-authorizations for elective surgery cases.
• Uploads faxes, letters and appeal letters to the account in care manager.
• Prepares monthly departmental reports.
• Assists Director of Utilization Management by creating meeting invites, PowerPoints, and work orders.
• Order supplies for the office and manage general office communications.

Skills

Thought leader

Team player

Enthusiastic

Dedicated

Flexibility

Goal orientation

Impact mindset

Job description

LIBERTY STREET HOSPITAL
MEADVILLE, PA 16335, USA

Reviews accounts as well as communicates with insurance companies to get appeal determinations.

Responds to telephone calls and messages from patients, insurance companies and staff courteously and promptly with an emphasis on effective resolution.

Reviews accounts to see if payment has been received and keep documentation log

Create and maintain department spreadsheets

Demonstrates knowledge of organizational policies regarding insurance appeals

Generates special reports as needed.

Assist Director of Utilization Management by creating meeting invites, PowerPoints, and work orders as needed. Will also assist Director with different case issues that come up throughout the day

Verify surgical pre-authorizations for elective surgery cases

Notify insurances of discharges

Assist with general cleanliness of department

Upload all faxes, letters and appeal letters to the account in care manager.

Demonstrates knowledge of various insurance programs regarding covered and non-covered services.

Notifies administrative personnel of important situations or problems.

Prepares monthly departmental reports

Ensures compliance in all regulatory areas.

Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.

Work with Denials staff and assist as needed

Order supplies for the office as needed

Answers office mainline phone and directs calls as needed

Takes care of sorting all faxes and communications received via mail etc and distributing to staff in timely manner

Responsible for assisting with MOON distributions to observation patients and certified mailings

Performs other duties as assigned.

Qualifications

Behaviors

Required

Functional Expert

• Considered a thought leader on a subject

Team Player

• Works well as a member of a group

Enthusiastic

• Shows intense and eager enjoyment and interest

Dedicated

• Devoted to a task or purpose with loyalty or integrity

Motivations

Flexibility

• Inspired to perform well when granted the ability to set your own schedule and goals

Goal Completion

• Inspired to perform well by the completion of tasks

Ability to Make an Impact

• Inspired to perform well by the ability to contribute to the success of a project or the organization

Equal Opportunity Employer
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