{"id":2439223,"url":"https://alion.io/job/access-integra-utilization-management-coordinator-integra-partners","title":"Utilization Management Coordinator - Integra Partners","company":{"id":4418690,"name":"2024 Integra Partners LLC","domain":"accessintegra.com","url":"https://alion.io/company/accessintegra","size_band":"51-200","is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"JazzHR","truth_index":null},"role":"Administrative","role_family":"Administrative","seniority":null,"employment_type":null,"work_mode":"remote","remote_scope":"stated_countries","remote_scope_basis":"posting_text","remote_working_hours":null,"hiring_geo_confidence":"inferred","locations":[],"countries":[],"hiring_countries":["US"],"hiring_countries_total":1,"salary":{"min":19,"max":null,"currency":"USD","period":"hour","gross":null,"usd_annual":38000},"salary_estimate":null,"experience_years_min":null,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[{"name":"Outlook","optional":false}],"status":"live","first_seen_at":"2026-10-13T11:35:48Z","employer_posted_date":"2026-10-13","last_verified_at":"2026-10-13T21:05:43Z","board_verified":true,"closed_at":null,"days_open":1,"trust":{"level":"ok","repost_count":null,"flags":[],"days_open":1},"description":"The UM Coordinator assists and supports the clinical team (UM Nurses/Medical Director) with administrative and non-clinical tasks related to processing Utilization Management prior authorization sand appeals.\nJOB RESPONSIBILITIES\nMonitor incoming faxes\nEnter UM authorizations review requests in UM platform using ICD-10 and HCPCS codes\nVerify eligibility and claim history in proprietary claims platform\nVerify all necessary documentation has been submitted with authorization requests\nContact requesting providers to obtain medical records or other necessary documentation related to specific UM request\nGenerate correspondence and assist with faxing/mailing member and provider notifications\nComplete verbal notifications\nDocument as required in authorization platform\nInitiate appeal cases and forward to UM Nurses for completion\nMeet internal and regulator deadlines for UM cases\nComplete tasks assigned by UM Nurses and document as required\nComplete inquiries received from call center and other internal & external sources\nOther duties as assigned by UM Director\nStrong organizational skills, ability to adapt quickly to change and desire to work in a fast-paced environment\nTeam oriented and self-motivated with a positive attitude\nPay: $19.00/hour\nWhat will you learn in the first 6 months?\nVerbal notifications\nHow to work in authorization systems Essette and Salesforce\nIncoming/outgoing faxing process\nUnderstanding the expectations and functions of the UM team\nTime Management\nWhat will you achieve in the first 12 months?\nExpand knowledge of ICD-10 and HCPC codes\nMaintaining expected timelines\nEXPERIENCE:\n1 year as a UM Coordinator in a managed care payer environment preferred\nKnowledge of ICD-10, HCPCS codes and medical terminology required\nAbility to prioritize multiple tasks using time management and organizational skills\nStrong computer skills with proficiency in Word, Outlook and other software applications\nAbility to collect data, establish facts and draw valid conclusions\nEffective written and oral communication skills\nExperience with DMEPOS desired\nMedicare/Medicaid experience a plus\nBenefits Offered\nCompetitive compensation and annual bonus program\n401(k) retirement program with company match\nCompany-paid life insurance\nCompany-paid short term disability coverage (location restrictions may apply)\nMedical, Vision, and Dental benefits\nPaid Time Off (PTO)\nPaid Parental Leave\nSick Time\nPaid company holidays and floating holidays\nQuarterly company-sponsored events\nHealth and wellness programs\nCareer development opportunities\nRemote Opportunities\nWe are actively seeking new colleagues in: Arizona, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Kentucky, Massachusetts, Michigan, North Carolina, Nevada, New Jersey, New York, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Washington.\nOur Story\nFounded in 2005, Integra Partners is a leading national durable medical equipment, prosthetic, and orthotic supplies (DMEPOS) network administrator. Our mission is to improve the quality of life for the communities we serve by reimagining access to in-home healthcare. We connect Payers, Providers, and Members through innovative technology and streamlined workflows affording Members access to top local Providers and culturally competent care. By focusing on transparency, accountability, and adaptability, we help deliver better health outcomes and more efficient management of complex healthcare benefits.\nWith a location in Michigan plus a remote workforce across the United States, Integra has a culture focused on collaboration, teamwork, and our values: One Team, Drive Results, Push the Boundaries, Value Others, and Build Community. We’re looking for energetic, talented, and dedicated individuals to join our team. See what opportunities we have available; there may be a role for you to engage in a challenging yet rewarding career in healthcare. We look forward to learning more about you.\nIntegra Partners is an equal opportunity employer. We are committed to providing reasonable accommodations and will work with you to meet your needs. If you are a person with a disability and require assistance during the application process, please don’t hesitate to reach out. 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