UM Coordinator: Appeals, Analytics & Admin Support

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 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.