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We are currently seeking an experienced:

UTILIZATION MANAGEMENT ADMINISTRATIVE COORDINATOR

Full Time, Days

SUMMARY:

• Day-to-day assistance with the management of the Utilization Management department and all Utilization Management activities, which include authorization, timeliness, documentation, including the adherence to policies and procedures to ensure high quality and cost-effective utilization management services.
• Quality monitoring focusing on fax and authorization queues, and other documents incoming and outgoing.
• Assist Utilization Management RNs and Director with projects as needed.
• Attend and contribute to all internal Utilization Management meetings
• Ability to be an interactive UM team member to ensure compliant execution of UM program
• Review admissions and service requests for the following:
• Monitor authorization requests, queues, medical documents, and approaching timelines.
• Occasional assistance with co-workers with issues related to coding, medical records/documentation, pre-certification reimbursement and claim denials/appeals
• Use critical thinking and problem-solving to navigate through the complexities of the Managed Care program guidelines.
• Ability to focus on interventions for improvement
• Provides appropriate responses to providers regarding UM questions, or request the assistance of the UM RNs or Direct of Utilization Management.
• Assist the department with the development of written policies, procedures and workflows
• The ability to be a part of the on-call rotation when needed.

JOB REQUIREMENTS:

• High School Diploma or equivalent required
• 3–5 years of experience in a medical office or health insurance company, preferably with a Health Plan
• Expert in medical terminology
• Excellent Organization and Priority skills
• Excellent computer skills and ability to learn new systems required.
• Strong attention to detail, organizational skills, and interpersonal skills required.
• Demonstrated ability to problem-solve and manage professional relationships.
• Healthcare industry knowledge, preferred
• Excellent listening, verbal, written and interpersonal communication skills.
• High level of professionalism and confidentiality, with a strong customer focus.
• Can adapt well to operational needs with excellent follow-up skills.
• Must be self-motivated, with a work ethic of dedication and the discipline to work independently.
• Must have a valid driver’s license.
• Proven ability to communicate concisely and confidently with all staff levels. Can clearly communicate instructions to remote users.

Visit www.libertycareers.com for more information.
Background checks/drug-free workplace.
EOE.