UM Coordinator I: Drive Access to Quality Care

PacificSource; Charlotte (NC); Sur place; USD 36 000 - 57 000; Plein temps

Résumé du poste

PacificSource is seeking a Utilization Management (UM) Coordinator I in Charlotte, NC to support preauthorization and case documentation. The role focuses on data accuracy, regulatory compliance, and effective collaboration with medical staff to ensure appropriate care.

The candidate should have 2+ years in health insurance or medical settings, with CPT/HCPCS/ICD coding familiarity and a high school diploma or equivalent; additional coding certifications are preferred.

Qualifications

• Two years of health insurance industry or medical setting experience.
• Experience with CPT/HCPCS/ICD coding preferred.
• High school diploma or equivalent required; advanced certifications preferred.

Responsabilités

• Coordinate UM cases and document preauthorization details.
• Assist with HIPAA privacy compliance and member/provider communications.
• Collaborate with clinical staff to improve utilization management processes and workflow.

Connaissances

Customer service

Communication skills

Problem solving

HIPAA compliance

Formation

High School Diploma or equivalent

Associate degree or medical assisting certification preferred

Certified professional coder (CPC) preferred

Outils

Microsoft Office

Medical claims software

Description du poste

PacificSource is seeking a Utilization Management (UM) Coordinator I in Charlotte, NC to support preauthorization and case documentation. The role focuses on data accuracy, regulatory compliance, and effective collaboration with medical staff to ensure appropriate care.

The candidate should have 2+ years in health insurance or medical settings, with CPT/HCPCS/ICD coding familiarity and a high school diploma or equivalent; additional coding certifications are preferred.