UM Coordinator; Inpatient

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. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them.

Together.

We are seeking an organized, detail-oriented and customer service oriented inpatient utilization management (UM) coordinator to join the remote UM team. As an inpatient UM coordinator, you will assist with managing census and admissions, retrieve medical records, and discharge planning while working with the case management (CM) supervisor, manager, and director of healthcare services.

Monday - Friday, 8am - 5pm Pacific Time (Required)

• 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 participate, as appropriate.
• Recognize work‑related problems and contribute 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.

• 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

• Medical assistant experience preferred
• Knowledge working in Access Express / Portal, Epic preferred.

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

• Medical Terminology Certificate preferred.

• None indicated.

• 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.

$41,472.00 - $62,208.00

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.

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