Utilization Management Rep
2 weeks ago
We are looking for a utilization management representative to join our team. This position is a remote role but you must live in Indiana to be eligible. This role is Monday - Friday 8am- 5pm EST and the pay for this role is $18.00/hr.
- Responsible for coordinating cases for precertification and prior authorization review
- Managing incoming calls or incoming post services claims work.
- Determines contract and benefit eligibility
- Provides authorization for inpatient admission, outpatient certification, and post service requests
- Refers cases requiring clinical review to a nurse reviewer
- Responsible for the identification and data entry of referral requests into the UM system
- Responds to telephone and written inquiries from clients, providers and in-house departments
- Other duties as assigned
Requires:
- HS Diploma/GED
- Minimum 1 year of customer service experience or call-center experience or any combination of education and experience
- Medical terminology training and experience in the medical or insurance field is preferred
- Needs to have strong oral, written and interpersonal communication skills, problem-solving skills, and analytical skills
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Indianapolis, United States Professional Management Enterprises Full timeJob DescriptionJob DescriptionDescription:Ideal candidate will have Behavioral Health experience in a health care setting and or Utilization Review/ Case Management. This is a full-time position Sunday-Thursday 8am-5pm. The pay for the role is $76,000/yr. This position is primarily provider facing.· Uses appropriate screening criteria knowledge and clinical...
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Found in: Talent US C2 - 2 weeks ago
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Found in: beBee S US - 2 days ago
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Found in: beBee jobs US - 6 days ago
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Found in: Resume Library US A2 - 2 weeks ago
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