Position Details
About this role
This role supports clinical and administrative tasks related to utilization management, including prior authorizations, documentation, and appeals within a healthcare environment.
Key Responsibilities
- Monitor incoming faxes
- Enter UM review requests
- Verify eligibility and documentation
- Contact providers for records
- Support authorization and appeals
Technical Overview
The technical environment involves authorization platforms like Essette, healthcare coding standards ICD-10 and HCPCS, and medical documentation management.
Ideal Candidate
The ideal candidate is an entry-level or experienced UM Coordinator with knowledge of ICD-10, HCPCS, and medical terminology, capable of supporting authorization and appeals processes in a healthcare setting.
Must-Have Skills
Nice-to-Have Skills
Tools & Platforms
Required Skills
Hard Skills
Soft Skills
Industry & Role
Keywords for Your Resume
Deal Breakers
Lack of healthcare or UM experience, No familiarity with ICD-10 or HCPCS, Inability to work remotely
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