Utilization Management Coordinator

  • Allina Health
  • Minneapolis, MN, USA
  • Feb 14, 2020

Job Description

Allina Health is dedicated to the prevention and treatment of illness and enhancing the greater health of individuals, families and communities throughout Minnesota and western Wisconsin. A not-for-profit health care system, Allina Health cares for patients from beginning to end-of-life through its 90+ clinics, 12 hospitals, 16 pharmacies, specialty care centers and specialty medical services that provide home care, senior transitions, hospice care, home oxygen and medical equipment, and emergency medical transportation services. Allina Health is a vibrant, growing organization with opportunities to suit your professional skills and a diverse work environment to match your specific interests. We believe employees are our greatest asset and are dedicated to helping you develop and maximize your professional skills. The Commons, located in Minneapolis, is the headquarters of Allina Health, a not-for-profit health care organization serving patients and communities. Approximately 1,600 corporate and administrative service employees work at offices within Midtown Exchange, the site of the historic Sears retail complex at Chicago Avenue and E. Lake Street. This community landmark, adjacent to the campus of Abbott Northwestern Hospital, part of Allina Health, is the second largest building in Minnesota and includes offices, an internationally themed public market and residential units. Responsibilities Req ID: 62262 Provides administrative support for utilization management processes Triage and manage payer correspondence via phone, fax or mail. Refers cases to the Utilization Management Specialist as appropriate. Processes and/or obtains authorizations/certifications based on payer requirements Complete prior authorization, pre-certification and/or notification to payers as required for hospital admissions, treatments or procedures Completes follow up actions with payer as needed Identifies insurance requirements for authorization and obtains required information from the medical record for submission to the payer. Facilitate concurrent and/or claim denial process Refers cases to the Utilization Management Specialist as appropriate. Promotes cohesiveness and peer support among department staff and colleagues. Acts as a resource to others to assure department tasks are completed timely. Utilizes strong interpersonal communication skills and effective conflict resolution skills to foster mutually respectful and cooperative working relationships Keeps supervisor advised of problems, ideas or decisions. Education High School Grad or GED Equivalent. Some College. Qualification/Skills 3+ years experience in healthcare business office/insurance operations required; prefer experience working with clinical staff and administration in inpatient and outpatient healthcare settings; prefer experience with payor/managed care UM/UR requirements, customer service experience, PC skills and experience. Previous experience with revenue cycle and billing. Previous experience with insurance and registration processes. This position requires critical thinking skills, a strong work ethic, a desire to achieve customer service excellence, the ability to multi-task and handle a fast paced environment, extreme comfort and proficiency with using a PC, and web based applications. Work Schedule Days, Mon-Fri 20 hours per week Non-contract Benefit Eligible No weekends Location/Community Information Minneapolis boasts being both cosmopolitan yet small enough that you can find a place to call home whether on a lake, golf course, or in an adjoining suburb. With the fast pace of activity there are professional sports, theater, or enough parks for a quiet walk. The area has numerous schools and colleges, both public or private, and enough teams for all weekend athletes to join. Located in Minneapolis Population = 380,000 Service Area = 2,882,245 Community Resource Links: Community Information School Digger Explore Minnesota MN Dept of Education Minneapolis St. Paul MagazineSt. Paul Pioneer Press Twin Cities Living MagazineStar Tribune Closing If you are interested in becoming part of our award winning team of professionals, please apply online today. Allina Health is committed to providing Equal Employment Opportunities to all employees and applicants. EO M/F/Disability/Vet Employer.



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