Remote UM Coordinator

Job Summary

A company is looking for a Remote Utilization Management (UM) Coordinator.

Key Responsibilities:

• Monitor fax folders and verify eligibility for services
• Enter pre-service requests in the system and process medical service requests
• Contact providers for necessary documentation and maintain call documentation for expedited requests

Required Qualifications:

• Minimum 1 year experience in a medical setting with IPAs
• Knowledge of ICD10, CPT codes, Managed Care Plans, and referral systems
• High School Diploma or equivalent education and experience
• Knowledge of Medicare Managed Care Plans and proficiency in Microsoft Office
• Experience with UM criteria and bilingual English/Spanish preferred