Utilization Management Administration Coordinator - SNF (Healthcare)

Location: Remote nationwide within the United States; occasional travel to hirify.global offices for training or meetings may be required.

Salary: $40,000–$52,300 per year

Company

hirify.global is a U.S. healthcare and insurance company providing insurance and healthcare services through hirify.global and CenterWell.

What you will do

• Provide non-clinical administrative support for utilization management policies and services in the skilled nursing facility segment.
• Manage NLPs for chart reviews and build or pend authorizations for nursing team review.
• Conduct inbound and outbound calls with providers and members to verify clinical information, admission status, and discharge dates.
• Request clinical information from providers and facilities, document calls, and attach received records.
• Create written correspondence and distribute determination letters.
• Collaborate with providers, nursing teams, and multiple internal departments.

Requirements

• At least 1 year of experience in an administrative support role.
• Professional experience with Microsoft Word, Outlook, and Excel, including typing and data entry.
• Ability to learn and use new systems at a proficient to advanced level.
• Work from a dedicated, interruption-free space to protect member PHI and HIPAA information.
• Home internet must provide at least 25 Mbps download and 10 Mbps upload speeds.

Nice to have

• Experience with utilization review or prior authorization in a managed care organization.
• Experience with electronic medical records, medical terminology, or ICD-10 codes.
• Member service or customer service telephone experience.
• Experience with skilled nursing facilities, home health, CGX, SRO, or HCHB.
• Experience in a metric-driven healthcare environment.

Culture & Benefits

• Fully remote work with company-provided telephone equipment.
• Internet expense payments are available every two weeks for eligible employees working from home in California, Illinois, Montana, or South Dakota.
• Medical, dental, and vision benefits.
• 401(k) retirement savings plan, paid time off, company and personal holidays, and paid parental and caregiver leave.
• Short- and long-term disability coverage, life insurance, and other wellness benefits.