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Utilization Management Coordinator

JOB SUMMARY

The Utilization Management Coordinator for Value-Based RCM, Inc. (VBRCM) is responsible for proactively engaging payors with the purpose of securing authorizations for patient care.

MAJOR AREAS OF FOCUS

  • Prior Authorizations

  • Customer Service

RESPONSIBILITIES

  • Use, protect, and disclose patient protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards

  • Exhibit professional behavior and communication skills representative of VBRCM's commitment to superior customer service

  • Utilize system tools, dashboards, payer websites, payer portals, etc. in an effort to secure authorizations in a timely manner

  • Collaborates with VBRCM leaders on potential cause and effect understandings

  • Works as a team player

  • Perform other duties as assigned

KNOWLEDGE AND SKILLS

  • Ability to work independently and as part of a team

  • Knowledge of reimbursement and regulatory standards

  • Demonstrated experience in prior authorization process

  • Basic computer skills

  • Innovative, enthusiastic, creative, problem-solving skills

  • Ability and desire to work in a remote environment

  • Strong organizational skills and attention to detail

EDUCATION AND EXPERIENCE

  • High school diploma or GED

  • Previous medical billing experience required

  • Proficient in Microsoft office (Excel, Word, and PowerPoint)

JOB LOCATION

Remote

PHYSICAL REQUIREMENTS

  • Prolonged periods sitting at a desk and working on a computer

  • Must be able to lift up to 15 pounds at times

JOB TYPE

Full-time

HOURLY RATE

$19 - $24 per hour

BENEFITS

  • Paid time off

  • Work from home

  • Company-sponsored medical, dental, and vision insurance

SCHEDULE

  • Monday to Friday

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