JOB SUMMARY

The UM Referral Coordinator verifies patient benefits on requests, works with eligibility and benefit findings on referrals, contacts provider offices to obtain missing or illegible medical documentation, contacts members when needed, composes denial letters, and understands the denial process. Operates under the general supervision of the UM Director, Supervisor and Medical Director.

QUALIFICATIONS

· Minimum two years’ experience in Utilization Management or Utilization Review Preferred

· Medical Assistant with 3 plus years preferred

SKILLS

· Must have effective communication, facilitation, interpersonal and professional diplomacy skills.

· Strong attention to detail with ability to manage multiple priorities while meeting deadlines.

· Able to Problem-solve, negotiate and demonstrate independent decision-making.

· Strong communication skills in both oral and written form.

· Positive attitude and takes a team approach.

· Maintain strong skills in diplomacy, professionalism and trustworthiness.

· Familiarity with Microsoft applications, which include the ability to learn new computer systems and applications.

· Ability to manage multiple priorities and projects.

· Detail oriented with desire for producing work with 100% accuracy.

· Excellent analytical and problem-solving skills.

As an Equal opportunity employer, DBA Choice Medical Group is committed to a diverse workforce. Employment decisions regarding recruitment and selection will be made without discrimination based on race, color, religion, national origin gender, age sexual orientation, physical or mental disability, genetic information or characteristic, gender identity, and expression, veteran status, or other non-job related characteristics or other prohibited grounds specified in applicable federal, state and local laws. In order to ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Era Veterans’ Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact this post for assistance.

For more information about equal employment opportunity protections, please view the ‘EEO is the Law’ poster.

NOTICE: EMPLOYEE POLYGRAPH PROTECTION ACT

YOUR RIGHTS UNDER THE FAMILY AND MEDICAL LEAVE ACT

PAY TRANSPARENCY NONDISCRIMINATION PROVISION

Our environment respects individual differences and recognizes each employee as an integral member of our company. Our workforce reflects these values and celebrates the individuals who make up our growing team.

Choice Medical Group provides a work environment free of harassment and prohibited conduct. We promote and support individual differences and diversity of thoughts and opinion.

Job Type: Full-time

Pay: $16.00 - $19.00 per hour

Schedule:

• 8 hour shift
• Monday to Friday

Education:

• High school or equivalent (Preferred)

Experience:

• Health Insurance Verification Occupations: 1 year (Preferred)
• Utilization Management: 1 year (Preferred)
• Medical Assistant: 1 year (Preferred)

Work Location: One location