UM Coordinator
at Ronin Staffing

Date Posted: 10/19/2019

Job Description

HERE’S THE JOB DESCRIPTION:
Title: UM Coordinator 
Pay: DOE
Location: Commerce, CA 90040
Duration: 5 month contract + possible extension

Job Description:

  • This position is responsible for providing support to the Medical Management department to ensure timeliness of outpatient or inpatient referral/authorization
  • processing per state and federal guidelines. This position performs trouble-shooting
  • Input data into the Medical Management system to ensure timeliness of referral/authorization processing.
  • Verifies member benefits and eligibility upon receipt of the treatment authorization request.
  • Utilizes authorization matrix, ancillary rosters, DOFR, and/or delegation agreements to drive decision-making.
  • Coordinates with referral nurse and/or Medical Director for timely referral processing.
  • Ensure timely provider and member oral and written notification of referral decisions.
  • Ensures proper notification of patient facility admissions with PCP and NOMNC when applicable.
  • Coordinate board certified referrals with partner vendors.
  • Coordinates and assists with patient appointments as needed and notify patient of authorization status.
  • Performs trouble-shooting when problems situations arise and coordinates with leadership.
  • Prepares denial letters for review by Medical Director or Nurse Reviewer(s) and distributes letters to appropriate recipients.
  • Demonstrates excellent communications skills and interpersonal relationships.
  • Collaborates and facilitates interdisciplinary team communications.
  • Perform additional duties as assigned.
  • Process referrals within the dept. targets based on workflows and technology.
  • Meets inter-rater minimum standards for core responsibilities.

Required/Desired Skills:

  • UM Experience – Required 1 Year

Job Snapshot

About Us

Founded in 1999 as a woman- and minority-owned IT staffing organization, Ronin Staffing has grown into a full-service staffing search firm that recruits and places qualified and quality candidates with expertise in a wide range of areas, including Engineering, Aerospace, Administration, Accounting/Financing, to name a few. We offer contract-only, contract-to-hire or direct-hire services to our clients and our contractors alike.

Our team of experienced, dynamic and tenacious recruiting specialists will provide you with the personal assistance you need to keep your career moving onward and upward. Whether you are looking for hourly, mid-management or executive level positions, you can be confident in our recruiters’ ability to match you with just the right assignments with just the right companies to suit your needs. Many members of our staff have backgrounds in the industries for which they now recruit, and Ronin has become one of the leaders in providing professionals to Fortune 100, 500, and 1000 companies.

We are proud to offer you a full line of services to help you to meet your career objectives, including resume assistance, human resources consulting, and expert guidance on professional interviewing techniques. We also offer direct deposit and a competitive benefits package.

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