Utilization Management Intake Coordinator remote- MediGold Health Plan
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Job Location:
Columbus, NE - USA
Monthly Salary:
Not Disclosed
Posted on:
19 hours ago
Vacancies:
1 Vacancy
Job Summary
Employment Type:
Full timeShift:
Day ShiftDescription:
Why MediGold
Position Purpose
The Coordinator Utilization Management Intake performs duties to support the Utilization Management department including management of internal and external calls managing/triaging all departmental authorization/referral requests and assisting in compliance-driven auditing and reporting.
What You Will Do:
- Assists with the management of departmental processes auditing and reporting deliverables and initiatives in compliance with federal and state regulatory agencies.
- Receives interprets and responds to evaluation utilization review inquiries
- Manages incoming medical records authorization requests and referrals for department.
- Manages department call tracking system and triage incoming calls as appropriate.
- Coordinates oversees records and transmits information pertinent utilization review processes.
- Assists with administrative responsibilities such as meeting preparation minutes mailings faxing/scanning department records ordering of departmental suppliesetc.
- Responsible for performing a variety of tasks requiring independent judgement and initiative.
- Establishes and maintains effective working relationships with other departments.
- Establishes and maintains strong positive communication with key stakeholders.
Minimum Qualifications:
- Education: High School required; Bachelors degree preferred
- Experience: Minimum of two (2) years data entry experience with healthcare field preferred.
- Effective Communication Skills
- Understanding of medical terminology required.
- Must have in-depth computer skills including word processing software (e.g. Microsoft
- Office) and data entry.
- Ability to work independently with minimal supervision.
- Must be able to document data accurately into computer system and maintain statistical
- records and reports.
- Must possess a high degree of motivation initiative and organizational ability.
- Familiarity with managed care and claims processing required including CPT & ICD-10
- coding phone triaging referrals and authorizations.
- Must be able to maintain confidentiality of work documents.
- Knowledge of managed care issues related to utilization management plan benefits and provider contacts.
- Ability to work with physician offices in facilitating authorizations.
Position Highlights and Benefits:
- Mount Carmel Health System recognized by Forbes in 2025 as one of Americas Best State Employers.
- Competitive compensation and benefits packages including medical dental and vision with coverage starting on day one.
- Retirement savings account with employer match starting on day one.
- Generous paid time off programs.
- Employee recognition programs.
- Tuition/professional development reimbursement starting on day one.
- RN to BSN tuition 100% paid at Mount Carmels College of Nursing.
- Relocation assistance (geographic and position restrictions apply).
- Employee Referral Rewards program.
- Mount Carmel offers DailyPay - if youre hired as an eligible colleague youll be able to see how much youve made every day and transfer your money any time before deserve to get paid every day!
- Opportunity to join Diversity Equity and Inclusion Colleague Resource Groups.
Ministry/Facility Information:
Mount Carmel a member of Trinity Health has been a transforming healing presence in Central Ohio for over 135 years. Mount Carmel serves over 1.3 million patients each year at our five hospitals free-standing emergency centers outpatient facilities surgery centers urgent care centers primary care and specialty care physician offices community outreach sites and homes across the region. Mount Carmel College of Nursing offers one of Ohios largest undergraduate graduate and doctor of nursing programs. If youre seeking a rewarding career where your purpose passion and desire to make a difference come alive we invite you to consider joining our team. Here care is provided by all of us For All of You!
We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race color sex age national origin religion sexual orientation gender identity status as a veteran and basis of disability or any other federal state or local protected class.
Our Commitment
Rooted in our Mission and Core Values we honor the dignity of every person and recognize the unique perspectives experiences and talents each colleague brings. By finding common ground and embracing our differences we grow stronger together and deliver more compassionate person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity national origin disability veteran status or any other status protected by federal state or local law.
Required Experience:
IC
Key Skills
- EMR Systems
- Employee Relations
- Typing
- Patient Care
- Clerical Experience
- HIPAA
- Computer Skills
- EMT Experience
- Medical Terminology
- Transcription
- Epic
- Phone Etiquette
About Company
Trinity Health is one of the largest not-for-profit, Catholic health care systems in the nation. It is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians caring for diverse communities across 25 states. Nationally recognized for care and experience, the Trinity ... View more
