Utilization Management Coordinator

19 hours ago


St Augustine, Florida, United States UF Health Full time
Job Summary

We are seeking a highly organized and detail-oriented Utilization Management Assistant to join our team at UF Health. As a key member of our healthcare operations team, you will play a critical role in ensuring the smooth operation of our clinical programs.

Key Responsibilities
  • Issue regulatory letters, including Discharge Important Message from Medicare, MOON, and HOON, with proper documentation in AllScripts.
  • Monitor Sfax for insurance authorizations and denials, transferring relevant information to the appropriate RN Case Manager's Sfax folder.
  • Verify initial Important Message from Medicare, HOON, or MOON are properly scanned into SCM and documented in the ACM note.
  • Obtain current and retrospective insurance authorizations telephonically and notify the appropriate RN Case Manager.
  • Answer incoming calls to the department, transferring calls to the appropriate RN Case Manager's or Care Coordinator's phone.
  • Perform other duties as assigned by the department.
Requirements

A High School Diploma or equivalent is required for this role.



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