Utilization Management Coordinator I - Hybrid/Remote

PacificSource; Boise (ID); On-site; USD 36,000 - 57,000; Full time

Benefits offered by this job

Flexible telecommute policy

Medical, vision, and dental insurance

Incentive program

Paid time off and holidays

401(k) plan

Tuition reimbursement and training

Job summary

PacificSource, a respected health plan provider, seeks a dedicated team member for utilization management and related responsibilities. The role involves coordinating preauthorization, documenting cases, and liaising with members and providers to ensure appropriate care and timely authorizations.

The position requires familiarity with ICD/CPT/HCPCS, strong communication skills, and the ability to work across multiple systems while maintaining HIPAA compliance.

Qualifications

• Minimum two years in health insurance or medical setting.
• Proficiency in medical terminology and coding basics.
• Strong written and verbal communication skills.

Responsibilities

• Adhere to dependability, production and quality standards.
• Coordinate, document, and validate preauthorization and UM cases.
• Assist members and providers regarding prior authorizations and benefit utilization.

Skills

Customer service

HIPAA knowledge

Verbal communication

Problem solving

Organizational skills

Education

High school diploma or equivalent

Associate degree or medical assistant certification preferred

Tools

Microsoft Office

Claims management software

Job description

PacificSource, a respected health plan provider, seeks a dedicated team member for utilization management and related responsibilities. The role involves coordinating preauthorization, documenting cases, and liaising with members and providers to ensure appropriate care and timely authorizations.

The position requires familiarity with ICD/CPT/HCPCS, strong communication skills, and the ability to work across multiple systems while maintaining HIPAA compliance.