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:

H.S. Diploma,GED,or Equivalent

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 committed 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.