Summary
Effective coordination between IPA Management Company and Providers to ensure timely, accessible care/ services to members.
Duties and Responsibilities
Collects referrals request and sort according to IPA
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Separate Urgent/ Routine referrals.
Ensures referrals are entered timely
Answers UM phone and answers voice mails as needed
Verification of eligibly and make appropriate changes as needed
Review referral requests and call provider offices for additional information
Ensures emails are answered timely
Verification of requested providers
Distribute fax request according to department
Labeling of all incoming fax request
Work alongside coordinator and clinician as needed
Identify IPA provider network concerns
Assist with UM special projects
Attends Utilization Management meeting as requested
Communicate with Leadership to facilitate workflow and assignments
Minimum Job Requirements
- High school graduate
- One-year of data entry experience including keyboard, mouse and 10 key
- Ability to type 45 words per minute (WPM)
- ICD-10 knowledge
- Ability to enter data into computer quickly an accurately
Skills and Abilities
- Successful at working in a faced passed environment
- Possess the ability to work as a team, but also independent with limited direction
- Communicate effectively with both team and leadership
- Ability to maintain multiple deadlines, with strong follow through
- Strong interpersonal skills using tact, patience and courtesy
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