Appeals Back End UM Admin Coordinator

This is a fully remote position, open to applicants in United States.

📋 Description

• Deliver administrative assistance for utilization management programs and processes.

• Accurately review, process, and maintain information and records in a timely manner.

• Facilitate communications with internal teams and external stakeholders.

• Aid operational activities that ensure appropriate care and service delivery for members.

• Adhere to established policies, procedures, and work instructions.

• Manage workload effectively, uphold quality standards, and achieve performance expectations.

• Work collaboratively with team members to meet departmental and business objectives.

• Execute tasks under general supervision, exercising judgment within established guidelines.

⛳️ Requirements

• Proven experience in providing administrative, operational, customer service, or technical support in a professional setting.

• Excellent verbal and written communication skills.

• Proficient in Microsoft Office applications, including Word, Excel, and Outlook.

• Capability to learn new systems and technologies quickly.

• Ability to work independently in a remote work environment.

• Reliable internet connection that meets company standards: minimum 25 Mbps download and 10 Mbps upload.

• Strong organizational skills with keen attention to detail.

• Ability to manage multiple priorities in a dynamic and fast-paced environment.

• Dedication to providing exceptional service and enhancing customer and member experiences.

• Preferred experience with electronic medical record (EMR), healthcare documentation, or case management systems.

• Preferred knowledge of medical terminology, healthcare coding, or ICD-10 classifications.

• Preferred associate's or bachelor's degree in Business, Healthcare Administration, Finance, or a related field.

• Preferred background in customer service, member service, or call center environments.

• Experience supporting Utilization Management, Prior Authorization, Care Management, or related healthcare operations, ideally within a health plan or managed care setting.

🏝️ Benefits

• Medical, dental, and vision benefits.

• 401(k) retirement savings plan.

• Paid time off.

• Company holidays.

• Personal holidays.

• Paid parental leave.

• Paid caregiver leave.

• Short-term disability.

• Long-term disability.

• Life insurance.

• Telephone equipment suitable to meet business requirements.

• Bi-weekly internet expense reimbursement for employees residing and working from home in California, Illinois, Montana, or South Dakota.