Utilization Management Coordinator

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Job Summary:

Key Position Details:

This position will work within the Admissions office. Primary duties include data entry, phone communication with referral sources and family members, and meeting with patients and their families to complete the admission process.

• Full time position (80 hours every two-week period)
• 8-hour, day shifts - flexible start times - between 730a and 9a
• No weekend schedule

Job Description:

Responsible for completing operational functions within Utilization Management. Provide Utilization Management support services that are critical to support the accurate and timely utilization review of patients at Allina Health.

Principle Responsibilities

• Provides administrative support for utilization management processes.
• Triages and manages payer correspondence via phone, fax, or mail.
  • Dividing incoming work (faxes, phone-correspondence, mail) by priority level (prioritization) so that the highest priorities are handled first (time sensitive).
• Refers cases to the utilization management specialist.
  • High-level of coordination is required to ensure specific payer requirements are met; must be able to quickly review information from multiple sources and direct questions and concerns to the appropriate staff person for resolution; must provide timely feedback to payers that requires research and coordination of information from various areas including UM specialists.
  • Clarifying administrative requirements for patients with uncommon payers; receiving timely feedback from multiple sources; maintaining strong systems that ensure timely follow-up without losing focus on attention to details; keeping up with high volume of requests for information from multiple sources.
• Assists the UM Specialists in obtaining authorizations and certifications based on payer requirements.
  • Concurrent review follow-up and data retrieval for payer requirements to support review process for UMS.
• Facilitates concurrent claim denial process.
• Other duties as assigned.

Required Qualifications

• Must be 18 years of age with education and/or experience needed to meet required functional competencies as listed on the job description
• 0 to 2 years of business office experience

Preferred Qualifications

• High school diploma or GED
• Associate's or Vocational degree in business, healthcare, or related field preferred
• 2+ years of experience working healthcare business office
• 2+ years of experience working in insurance operations
• 2+ years of experience working in Epic
• 2+ years of experience working in Microsoft Office
• 2+ years of experience working with revenue cycle and billing

Physical Demands

• Sedentary:
• Lifting weight Up to 10 lbs. occasionally, negligible weight frequently

Pay Range

Benefit Summary

Allina Health believes the best way to provide safe and compassionate care for our patients is by nurturing the passion of those who care for them. That's why we devote extraordinary resources to help you grow and thrive - not only as a professional but also as a whole person. When you join our team, you have access to a wealth of valuable employee benefits that support the total well-being - mind, body, spirit and community - of you and your family members.

Allina Health is all in on your well-being. Because well-being means something different to everyone, our award-winning program provides you with the resources you need to help you navigate your personal journey. This includes up to $100 in well-being dollars, dedicated well-being navigators, and many programs, activities, articles, videos, personal coaching and tools to support you on your journey.

In addition, Allina Health offers employee resources groups (ERGs) -- voluntary, employee-led groups that serve as a resource for members and organizations by fostering a diverse, inclusive workplace aligned with the organization's mission, values, goals, business practices, and objectives. Allina Health also engages employees in various community involvement and volunteering events.

Benefits include:

• Medical/Dental

• PTO/Time Away

• Retirement Savings Plans

• Life Insurance

• Short-term/Long-term Disability

• Paid Caregiver Leave

• Voluntary Benefits (vision, legal, critical illness)

• Tuition Reimbursement or Continuing Medical Education as applicable

• Student Loan Support Benefits to navigate the Federal Public Service Loan Forgiveness Program

• Allina Health is a 501(c)(3) eligible employer

*Benefit eligibility/offerings are determined by FTE and if you are represented by a union.