UM Coordinator: Inpatient & Outpatient Authorizations

Imperial Health Plan of California, Inc.; Pasadena (CA); On-site; USD 50,000 - 65,000; Full time

Job summary

A healthcare organization in Pasadena seeks a UM Coordinator for inpatient and outpatient services. This role requires processing authorizations, ensuring accuracy, and providing necessary information to medical providers. Candidates should have strong communication skills and a minimum of one year in healthcare. Duties include handling incoming faxes, customer service calls, and maintaining compliance with regulations. This role is crucial for effective healthcare delivery.

Qualifications

• High school graduate or equivalent.
• 1 year of medical office or healthcare experience required.
• Must have experience in making outgoing phone calls as well as taking incoming phone inquiries.

Responsibilities

• Open and process UM incoming faxes periodically throughout the business day.
• Provide customer service to calls from providers and/or members.
• Print approvals and modification letters from the database on a daily basis.
• Scan faxes to existing authorizations in the system.
• Route medical reviewers' cases to appropriate personnel promptly.
• Verify duplicate requests and notify the doctor's office of cancellations.
• Contact and follow up with providers on pending documents.
• Verify and update missing information before submitting for approval.
• Adhere to payroll policies and use the timekeeping system responsibly.
• Maintain regular and consistent attendance.
• Adhere to Compliance Plan and HIPAA regulations.

Education

High school graduate or equivalent

1 year of medical office or healthcare experience

Job description

A healthcare organization in Pasadena seeks a UM Coordinator for inpatient and outpatient services. This role requires processing authorizations, ensuring accuracy, and providing necessary information to medical providers. Candidates should have strong communication skills and a minimum of one year in healthcare. Duties include handling incoming faxes, customer service calls, and maintaining compliance with regulations. This role is crucial for effective healthcare delivery.