2 месяца назад
Healthcare Utilization Management Coordinator (Healthcare)
Вакансия из Hirify Global, списка международных tech-компанийДля мэтча и отклика нужен Plus
Мэтч & Сопровод
Для мэтча с этой вакансией нужен Plus
Описание вакансии
Текст:
TL;DR
Healthcare Utilization Management Coordinator (Healthcare Administration): Coordinating prior authorizations, referrals, and utilization review activities for healthcare plans with an accent on administrative intake and document management. Focus on ensuring compliance with HIPAA and regulatory requirements while facilitating timely processing of medical requests.
Company
is a leading provider of back-office support technology and tech-enabled outsourced services to healthcare plans nationwide.
What you will do
- Receive, review, and process incoming prior authorization and referral requests, ensuring all documentation is complete.
- Monitor electronic fax queues to index, classify, and upload clinical documentation into the management system.
- Route cases to licensed clinical reviewers and track authorization status through to completion.
- Communicate with provider offices and members to resolve administrative inquiries and retrieve missing medical records.
- Maintain accurate authorization records in strict compliance with HIPAA, CMS, and NCQA regulations.
Requirements
- High School Diploma or equivalent.
- 1–3 years of experience in healthcare administration, utilization management, prior authorization, or care coordination.
- Knowledge of medical terminology.
- Strong attention to detail and organizational skills.
- Intermediate proficiency with Microsoft Office applications.
Culture & Benefits
- HMO Medical & Dental coverage from Day 1, including one dependent.
- Transportation and Internet allowances.
- Company-provided equipment.
Будьте осторожны: если работодатель просит войти в их систему, используя iCloud/Google, прислать код/пароль, запустить код/ПО, не делайте этого - это мошенники. Обязательно жмите "Пожаловаться" или пишите в поддержку. Подробнее в гайде →