Utilization Management Administration Coordinator, Phone Intake
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Job Description
Utilization Management Administrative Coordinator providing non-clinical support and assisting healthcare providers with referral authorizations. Responsible for gathering and processing requests accurately and efficiently.
Responsibilities:
- Providing high-quality support to healthcare providers contacting the call center to initiate referral authorizations or check the status of existing requests
- Respond promptly and professionally to incoming calls from providers
- Accurately gather, verify, and enter provider and member information into the appropriate systems
- Review and process referral authorization requests according to established UM protocols
- Collaborate with clinical and administrative staff to resolve issues
- Provide clear, concise, and courteous information regarding UM processes
- Monitor call queues and manage multiple tasks
- Identify and escalate complex or urgent cases to the appropriate staff
- Maintain thorough documentation of all interactions and transactions
- Participate in ongoing training and quality assurance activities
Requirements:
- 1 or more years administrative or technical support experience
- Excellent verbal and written communication skills
- Working knowledge of MS Office including Word, Excel, and Outlook in a Windows based environment
- Must have accessibility to high speed DSL or Cable modem for a home office (Satellite internet service is NOT allowed for this role)
- Bachelor's Degree in Business, Finance or a related field (preferred)
- Prior member service or customer service telephone experience desired
- Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization
Benefits:
- medical, dental and vision benefits
- 401(k) retirement savings plan
- time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
- short-term and long-term disability
- life insurance
- many other opportunities
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