POSITION: Utilization Management Intake Coordinator

SCHEDULE: Full Time, Monday-Friday

LOCATION: Remote, 1 day per week in office

Wexford Health Sources, Inc. Corporate Office

• Foster Plaza 4, Suite 300
• Green Tree - Pittsburgh, PA 15220

BENEFITS:

• Annual review with performance increase
• Generous paid-time off program that combines vacation and sick leave
• Paid holidays
• Comprehensive health insurance through Blue Cross Blue Shield
• Dental and Vision insurance
• 401(k) retirement saving plans
• Company-paid short-term disability
• Healthcare and dependent care spending account

POSITION SUMMARY

• The Intake Coordinator coordinates daily flow of information between sites and Utilization Management Department.
• Maintains and updates appropriate data input into the system assisting with data entry and outcome.
• Communicates with site to encourage compliance with Wexford's policy and procedures as they relate to Utilization Management.

DUTIES/RESPONSIBILITIES

• Emails daily reports to assigned sites, check confirmations and electronically files.
• Assures receipt of various reports from assigned facilities. Notifies Manager of UM of site non-compliance.
• Reviews Daily Activity Report (DAR) for unusual occurrences and ensures receipt of appropriate referral request forms from the site. Enters actual dates of services in computer database.
• Enters ER and inpatient admissions auths as well as discharge information into database, forwards information to inpatient nurse.
• Enters Authorizations for approved services into computer database as assigned.
• Enters retrospective referrals and notates reason for non-compliance for reporting purposes.
• Daily electronic scanning/e-mailing and filing of documents.
• Monitors and coordinates sending out sleep study and audioscope machines via FedEx. Sends emailed results of completed sleep studies to facilities.
• Communicates information regarding deaths to Risk Management as reported by facilities.
• Monitors receipt of various reports from facilities and documents weekly compliance.
• Various other tasks as needed for the department.

EDUCATION: High School Graduate or equivalent, specialized training in health care management or medical coding a plus.

REQUIRED EXPERIENCE: Microsoft Word, Microsoft Outlook, Excel

PREFERRED EXPERIENCE:

• Experience in medical records or a physician office
• Knowledge of ICD-10
• CPT coding experience

EOE/M/F/D/V