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Allina Health System Utilization Management Coordinator in Minneapolis, Minnesota

Date Posted: October 05, 2021 Department: 16001168 Revenue Cycle Management Utilization Management Shift: Day (United States of America) Hours Per Week: 40 Union Contract: Non-Union Weekend Rotation: None Job Summary: This position is responsible for completing the necessary work to ensure authorizations are met for payment purposes from our commercial and government payers. Job Description: Principle Responsibilities Provides administrative support for utilization management processes. Triages and manages payer correspondence via phone, fax, or mail. Refers cases to the utilization management specialist. Processes and/or obtains authorizations and certifications based on payer requirements. Completes prior authorization, pre-certification and notification to payers are required for hospital admissions, treatments, or procedures. Identifies insurance requirements for authorization and obtains required information from the medical record. Facilitates concurrent claim denial process. Other duties as assigned. Job Requirements High School or GED required Associate's or Vocational degree in business, healthcare, or related field preferred 2 to 5 Years experience working healthcare business office required or 2 to 5 Years experience working in insurance operations required 2 to 5 Years experience working in Epic preferred 2 to 5 Years experience working in Microsoft Office preferred 2 to 5 Years experience working with revenue cycle and billing preferred Leadership Capabilities See the Big Picture: Know where we are going as an organization. Use sound judgement and critical thinking to make good decisions that support our mission. I know where Allina is going and how my role fits into this picture I capture important lessons and share them to foster innovation I am good at anticipating the implications of my decisions I understand and apply the disciplines of continuous improvement Inspire Greatness: Inspire others by connecting their purpose to the broader mission. Lead others through change and celebrate success. I help my team connect to the broader mission I see and fulfill my role in motivating the team around me I celebrate success and help my partners see what is possible with change I call out and address unexpected roadblocks or problems Foster Learning and Growth: Role model growth, ongoing development and self-care. Empower, coach and encourage others to be at their best selves. I role-model self-care and ongoing development I share my knowledge and coach others to foster growth and success I demonstrate enthusiasm for learning I candidly advocate for the resources I need I support my colleagues in their development and growth Deliver Excellence: Set and align clear goals, measure results, and continually improve safety, quality, experience, and innovation. I take ownership of outcomes and fulfillment of goals I facilitate adjustments to assure positive results I work with a sense of urgency, concern and determination I use well-grounded approaches to create sustainable solutions repeatedly I engage and foster improvements to impact safety, quality, and efficiency Succeed Together:Connect with others authentically. Recognize the value of each individual and seek diverse points of view. Collaborate to succeed together. I consider how decisions might impact my colleagues I am generous in my commitment to supporting the needs of my partners I respect others' opinions, praise good work and encourage all team members to be involved I seek common ground and work to create mutually beneficial outcomes Functional Competencies Analytical Thinking: Practices investigative techniques to determine the best approach. Business Impact: Responsible for the team meeting goals and objectives. Collaboration: Creates internal alliances outside the immediate team or department. Communication Skills: Advanced communication skills involving complicated topics. Company Knowledge: Understand