• Utilization Management Coordinator I - Utilization…

    Rady Children's Hospital San Diego (San Diego, CA)


    JOB SUMMARY:

    Under the supervision of the Utilization Management (UM) Operations Supervisor, the UM Coordinator I's primary job function is to support UM operations by performing any non-clinical tasks. This includes, but is not limited to, initial authorization processing, (data entry, eligibility verification, benefits verification, and requesting required supporting documents from submitting provider offices), answering the phone (including all provider calls regarding authorization processing, claims related phone calls, and any other calls received via the provider call center lines), and appropriately processing required UM notifications (letters, faxes, etc.).

    MINIMUM QUALIFICATIONS:

     

    1 Year of Experience

     

    Strong critical thinking skills

     

    Excellent communication and interpersonal skills

     

    Associate's Degree or Bachelor's Degree can be accepted in lieu of experience

     

    Demonstrated commitment to valuing diversity and contributing to an inclusive working and learning environment

    PREFERRED QUALIFICATIONS:

    Associate's Degree

     

    Computer skills, including Excel, EZ Cap, Word, Outlook, and data entry systems

     

    Previous experience in the health care field, such as hospital, medical group, health insurance, or other Risk Bearing Organization (RBO)

     

    Knowledge of medical terminology, ICD-10 codes, CPT Codes, HCPC Codes, Health Plan benefits, or claims

     

    The current salary range for this position is $22.00 to $30.27

     

    Rady Children’s Hospital is caommitted to compensation that is externally competitive and internally equitable. We demonstrate this commitment by conducting regular market reviews to remain competitive with organizations of similar size in the nonprofit, healthcare sector. The range listed above does not represent the full salary range for the position but is the expected hiring range for qualified candidates. Compensation decisions consider a variety of factors including experience, education, licensure, unique skillsets, organizational need, and internal equity. This posting will remain open from the “date posted” until the hiring manager has determined there is a sufficient applicant pool or until the position is filled.

     

    EOE including disability/vet