UTLIZATION MANAGEMENT ADMINISTRATIVE COORDINATOR

UTLIZATION MANAGEMENT ADMINISTRATIVE COORDINATORLiberty Healthcare Management Wilmington, North Carolina, United StatesAbout this position There's no place like Liberty HealthCome explore career opportunities with Liberty Health, a dynamic leader in the healthcare industry. Join us! We are currently seeking an experienced: UTILIZATION MANAGEMENT ADMINISTRATIVE COORDINATORFull Time, DaysSUMMARY:Day-to-day assistance with the management of the Utilization Management department and all Utilization Management activities, which include authorization, timeliness, documentation, including the adherence to policies and procedures to ensure high quality and cost-effective utilization management services. Quality monitoring focusing on fax and authorization queues, and other documents incoming and outgoing. Assist Utilization Management RNs and Director with projects as needed. Attend and contribute to all internal Utilization Management meetings Ability to be an interactive UM team member to ensure compliant execution of UM program Review admissions and service requests for the following: Monitor authorization requests, queues, medical documents, and approaching timelines. Occasional assistance with co-workers with issues related to coding, medical records/documentation, pre-certification reimbursement and claim denials/appeals Use critical thinking and problem-solving to navigate through the complexities of the Managed Care program guidelines. Ability to focus on interventions for improvement Provides appropriate responses to providers regarding UM questions, or request the assistance of the UM RNs or Direct of Utilization Management. Assist the department with the development of written policies, procedures and workflows The ability to be a part of the on-call rotation when needed.