UM Intake Coordinator

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

📋 Description

• Manage prior authorization requests in accordance with departmental policies, regulatory standards, and client contractual obligations.

• Analyze workflows and policies to ascertain whether requests necessitate prior authorization review or redirection.

• Input request information into a proprietary system to create cases for medical and behavioral health reviewers.

• Handle requests received through fax, email, or provider portal.

• Reach out to physician offices to acquire any missing information.

• Submit and track IT tickets to resolve issues hindering case generation.

• Address requests swiftly and courteously while diligently gathering the required information.

• Achieve set Utilization Management Intake Objectives and Key Results.

• Work collaboratively with medical, behavioral health, and clinical reviewers, as well as Utilization Management leadership.

⛳️ Requirements

• High school diploma or GED is required.

• 1–3 years of experience in a Coordinator role involving prior authorization requests or relevant experience in healthcare related to claims or appeal & grievance.

• Prior experience in Oncology is preferred.

• Proficient in reading, writing, and speaking English fluently with patients and providers.

• Capable of adapting to changing situations and performing detailed tasks accurately.

• Proficient in using computer and Windows PC applications, with strong keyboard and navigation skills.

• Team-oriented with a strong work ethic and dedication to productivity.

• Able to meet established targets while managing workload and prioritizing tasks in a remote setting.

• A government-issued photo ID is required for identity verification.

• A comprehensive background check will be conducted.

• In-person I-9 verification is mandatory.

• May be required to undergo drug screening prior to employment.

• Must have high-speed internet with a minimum of 10 Mbps at home.

• Call center employees should be able to connect directly to the home internet router.

🏝️ Benefits

• Work/life balance.

• Flexible work arrangements.

• Autonomy to accomplish tasks effectively.

• Health insurance benefits available for qualifying employees.