SUPPLEMENTAL UM COORDINATOR - COMMUNITY HEALTH CHOICE
This job is no longer accepting applications.
Primarily responsible for the initiation of cases by data entry of clinical, demographic and product information into the Medical Management system, via telephone, fax or online portal. Electronically routes cases to the nurse for review and decision. Handles data entry of all precertification of inpatient and outpatient service request. Responsible for accurate case completion /quality and productivity standards while staying within compliance timeframes. Handles provider outbound calls according to departmental standards. Provides a high level of customer service while communicating with internal departments and provider office staff as it pertains to performance of job responsibilities. Works independently with minimal supervision.
1. Education/Specialized Training/Licensure: High School Diploma required. Associate's degree preferred
2. Work Experience (Years and Area): 2 years data entry experience in a healthcare setting such as medical clinic, hospital, or managed care. 1 year utilization management experience preferred.
3. Management Experience (Years and Area): N/A
4. Software Operated: Microsoft Office (Word, Excel, Outlook)
SPECIAL REQUIREMENTS: (Check Applicable Areas)
1. Communication Skills:
Writing /Composing: Correspondence / Reports
2. Other Skills: Analytical, Medical Terminology, MS Word, MS Excel
3. Advanced Education:
Advanced Training Specialty: Associate's degree preferred
4. Work Schedule: Flexible
5. Other Requirements:
Able to work independently under general instructions
RESPONSIBLE TO: Supervisor/Manager
EMPLOYEE SUPERVISED: None
Benefits and EEOC
Community employees’ benefits are provided by Harris Health. These benefits are designed to provide you with flexibility and choices in meeting your specific needs.
Community is an Equal Opportunity Employer.
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Note: Current Community Health Choice employees must log in to PeopleSoft via CITRIX to explore career opportunities as an internal candidate. Click HERE for instructions.
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Community Health Choice is a local, non-profit health plan that offers affordable coverage to Texans.