Utilization Management Administrative Coordinator

Utilization Management Insurance Coordinator:

• Coordinates and serves as primary point of contact for affiliate-level Utilization Management (UM) inquiries & requests for information from internal and external sources.
• Receives and documents UM requests including researching to determine appropriate action needed to complete request according to established processes.
• Monitors and completes accounts on multiple work queues in EPIC, including referrals and denials.

Denial Request Coordination:

• Serves as primary point of contact for affiliate-level denial inquiries from internal and external sources under direction of the Manager.
• Coordinates and logs incoming affiliate-level denial requests; maintains current knowledge of payer requirements and contact information.
• Collects and inputs data on P2P requests into designated database; maintains Denials Databases in an accurate and timely manner to support data analysis and reporting.

Administrative/Clerical Support:

• Answers telephones for assigned affiliates; screens calls and callers, referring them to appropriate person/department in timely manner as requested.
• Assists with preparation of reports, graphs, and statistical information as requested.
• Performs other related administrative, clerical, and secretarial functions as requested.