UM Coordinator, Inpatient (Remote | Part-Time Weekends | PT | Weekday Training Required)

E2E Alignment Healthcare USA, LLC; California; Ibrido; USD 41.000 - 62.000; Part-time

Descrizione del lavoro

Alignment Health is seeking an organized, detail-oriented remote UM Coordinator (inpatient) to join our UM team. This part-time weekend role requires availability every Saturday and Sunday during Pacific Time hours, assisting with census, records, and discharge planning.

You will work with CM Supervisor, Manager, and Director, undergo 4 weeks of weekday training, and handle referrals and authorizations while upholding confidentiality and high-quality service.

Competenze

• Inpatient concurrent review experience.
• Experience with census and admission management.
• Experience in discharge planning.
• Experience entering referrals and prior authorizations.
• Experience with Medicare Advantage.
• Experience with hospital and/or facilities backend admissions.
• Knowledge of medical terminology.
• Knowledge of ICD-10 and CPT codes.
• Knowledge of Medicare, HMO, MMO, managed care plans.
• Computer proficient.

Mansioni

• Enter census data for hospitals and SNFs; attach medical records.
• Obtain medical records from hospitals and SNFs.
• Attach records to authorizations.
• Enter referrals and authorizations in system with ICD-10/CPT coding.
• Monitor fax folders and respond to urgent requests.
• Complete tasks assigned by nurse and document them.
• Maintain facility contact documentation and member records.
• Assist with mailing or faxing correspondence to facilities.
• Attend case management presentations as appropriate.
• Maintain confidentiality and act as a positive team member.

Conoscenze

Inpatient reviews

Census management

Discharge planning

Referrals & authorizations

Medicare Advantage

Hospital admissions

Medical terminology

ICD-10 & CPT codes

Managed care knowledge

Computer proficiency

Medical assistant experience

Access Express/Portal

Epic knowledge

Formazione

GED or equivalent

Medical Terminology Certificate

Strumenti

Access Express/Portal

Epic

Descrizione del lavoro

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

Alignment Health is seeking an organized, detail-oriented, and customer service-oriented remote UM Coordinator (inpatient) to join our UM team. This is a part-time weekend role that requires availability every Saturday and Sunday during Pacific Time hours. As an Inpatient UM Coordinator, you will assist with managing census and admissions, retrieving medical records, and supporting discharge planning while working closely with the Case Management (CM) Supervisor, Manager, and Director of Healthcare Services. If you are hungry to learn and grow, want to be part of a growing organization, and make a positive impact in the lives of seniors, we're looking for you!

Work Schedule (Required)

• Every Saturday and Sunday
• Option A: 7:00 AM - 4:00 PM Pacific Time
• Option B: 11:00 AM - 7:00 PM Pacific Time

Mandatory Training Availability (Required)

• This position requires 4 weeks of mandatory weekday training
• Training is Monday through Friday, 4 hours per day, scheduled within the hours of 8:00 AM–5:00 PM Pacific Time
• Specific training hours may vary based on trainer availability and business needs
• Attendance is required throughout the full 4-week training period

General Duties / Responsibilities

• Assist team with daily census by entering face sheets for hospitals and skilled nursing facilities (SNF).
• Obtain medical records from hospitals and SNF’s.
• Attach medical records to authorizations.
• Enter referral requests / authorizations in system using ICD 10 and CPT coding.
• Monitor fax folders.
• Complete and document tasks as assigned by nurse.
• Maintain documentation on facilities contacted.
• Assist with maintaining and updating member’s records.
• Assist with mailing or faxing correspondence to facilities, related to, as needed.
• Request medical records from facilities, etc., related to members activities, as needed.
• Attend case management presentations and participates, as appropriate.
• Recognize work‑related problems and contributes to solutions.
• Meet specific deadlines and respond to various workloads by assigning task priorities according to department policies, standards and needs.
• Maintain confidentiality of information between and among health care professionals.
• Be a positive team player.

Experience

• Inpatient concurrent review experience
• Experience with census and admission management
• Experience in discharge planning
• Experience entering referrals and prior authorizations.
• Experience with Medicare Advantage
• Experience with hospital and / or facilities backend admissions
• Knowledge of medical terminology
• Knowledge of ICD10 and CPT codes
• Knowledge of Medicare, HMO, MMO, managed care plans
• Computer proficient
• Medical assistant experience preferred
• Knowledge working in Access Express / Portal, Epic preferred

Education

• High school diploma or general education degree (GED) or (4) years' additional experience in lieu of education.
• Medical Terminology Certificate preferred.

Specialized Skills

• Proficient in Microsoft Office (Outlook, Excel, Word)
• Able to type minimum 50 words-per-minute (WPM)
• Organized and detail oriented
• File systematically
• Good interpersonal skills
• Strong written, verbal, and telephonic communication skills
• Able to read, write, and speak English fluently

Licensure

• None

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Essential Physical Functions

1. While performing the duties of this job, the employee is regularly required to talk or hear.
2. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
3. The employee frequently lifts and / or moves up to 10 pounds.
4. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Pay Range

$41,472.00 - $62,208.00 Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

Alignment Health is championing a new path in senior care that empowers members to age well and live their most vibrant lives. Our mission-focused team makes high-quality, low-cost care a reality for members every day. Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most. We believe that great work comes from people who are inspired to be their best. We've built a team of people who want to make a difference in the lives of the seniors we serve. Come join the team that is changing health care — one person at a time.