Coordinator, UM Intake (Fax Admin)

Responsibilities

• Review Service Level Agreement Grids to determine appropriate turnaround timeframes (TAT) based on health plan, product type, line of business, code and priority.
• Monitor the failed fax dashboard to identify unsuccessful transmissions and coordinate the re-sending of correspondence via appropriate channels.
• Oversee and respond to requests in a shared email inbox by reviewing clinician inquires, retrieving requested clinical documents and attaching them for timely case review.

Requirements

• Assist with additional administrative tasks as assigned, demonstrating flexibility, strong attention to detail, and the ability to adapt to evolving department needs.
• Qualifications Required and Preferred: A high school diploma or GED. (Required) 1 – 3 years of
• (Required) Basic knowledge of medical records with the ability to locate and verify member details.
• (Required) Working knowledge of medical coding system including CPT/HCPCS codes to differentiate between medical and pharmacy prior authorization requests.
• (Required) Ability to adapt to fluctuating situations and perform work of a detailed nature, while avoiding errors.
• (Required) Proficient using computer and Windows PC applications (Outlook, Word, Excel and OneNote), which includes strong keyboard and navigation skills.
• (Required) Demonstrated ability meeting established goals while balancing a workload and prioritizing assignments in a remote environment.
• All candidates must complete a comprehensive background check, in-person I-9 verification, and may be subject to drug screening prior to employment.
• The use of artificial intelligence tools during interviews is prohibited and monitored.
• Requirements: We require that all employees have the following technical capability at their home: High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router.
• experience required for the position and commensurate with
• experience of selected individuals, which may vary above and below the stated amounts.

Benefits