UM Coordinator I: Care Access & Case Coordination

PacificSource; Bend (OR); On-site; USD 36,000 - 57,000; Full time

Benefits offered by this job

Flexible telecommute policy

medical, vision, and dental insurance

paid time off and holidays

401(k) plan

tuition reimbursement and training

Job summary

PacificSource is seeking a detail-oriented professional to support utilization management and care coordination in a health insurance setting. You will document cases, validate authorization requirements, and assist with referrals and benefits while maintaining HIPAA compliance.

Strong coding knowledge and customer service skills are essential. The role involves collaboration with clinical staff, handling calls, and ensuring accurate medical records across multiple systems.

Qualifications

• Two years of health insurance industry or medical setting experience preferred.
• Understanding of CPT/HCPCS/ICD coding and medical terminology is required.

Responsibilities

• Coordinate, document, and validate utilization management cases.
• Assist members with prior authorization, referrals, and benefit questions.
• Maintain HIPAA compliance and ensure data accuracy across systems.
• Collaborate with clinical staff to support utilization management and care coordination.

Skills

CPT/HCPCS/ICD coding

Customer service

Healthcare terminology

Education

High school diploma or equivalent

Associate degree preferred

Tools

Medical billing software

Job description

PacificSource is seeking a detail-oriented professional to support utilization management and care coordination in a health insurance setting. You will document cases, validate authorization requirements, and assist with referrals and benefits while maintaining HIPAA compliance.

Strong coding knowledge and customer service skills are essential. The role involves collaboration with clinical staff, handling calls, and ensuring accurate medical records across multiple systems.