Utilization Management Rep I
2 months ago
Location: Norfolk, VA/ Nashville, TN
Duration: 3 months
Description:
Responsible for coordinating cases for precertification and prior authorization review.
Primary duties may includes, but are not limited:
Managing incoming calls or incoming post services claims work.
Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, 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 in accordance with the plan certificate.
Responds to telephone and written inquiries from clients, providers and in-house departments.
Conducts clinical screening process.
uthorizes initial set of sessions to provider.
Checks benefits for facility based treatment.
Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner.
Requires High school diploma/GED; 1 year of customer service or call-center experience; proficient analytical, written and oral communication skills; or any combination of education and experience, which would provide an equivalent background. Medical terminology training and experience in medical or insurance field preferred.
Qualification:
General Business Skills Level
Oral Communication 3 and 2 years
Written Communication 3 and 2 years
-
Patient Access Rep I
3 weeks ago
Norfolk, United States Sentara Health Full timeCity/State Norfolk, VA Overview Work Shift First (Days) (United States of America) Sentara Health is currently seeking a Patient Access Representative at our Sentara Brock Cancer Center in Norfolk, Virginia. Up to $1,500Sign-On Bonus for Qualified Candidates! Hours/Shift: Full-Time, Days Sentara Benefits: We are setting the standard for medical...
-
Customer Service Rep I
2 days ago
Norfolk, United States Sentara Full timeCity/State Norfolk, VA Overview Work Shift First (Days) (United States of America) Sentara Health is currently recruiting for an In-Person,Full-TimeDay Shift Customer Service Rep I in Norfolk, VA. For the Billing Support ServicesatSentara Patient Accounting. The Customer Service Representativeis primarily responsible for handling incoming calls to...
-
Customer Service Rep I
1 month ago
Norfolk, United States Sentara Full timeCity/State Norfolk, VA Overview Work Shift First (Days) (United States of America) Sentara Health is currently recruiting for an In-Person,Full-TimeDay Shift Customer Service Rep I. For the Consolidated Medical Group departmentatSentara Patient Accounting. Primarily responsible for handling incoming calls to effectively address eligibility, claim, and...
-
Customer Service Rep I
4 weeks ago
Norfolk, United States Sentara Full timeCity/State Norfolk, VA Overview Work Shift First (Days) (United States of America) Sentara Health is currently recruiting for an In-Person,Full-TimeDay Shift Customer Service Rep I in Norfolk, VA. For the Consolidated Medical Group departmentatSentara Patient Accounting. Primarily responsible for handling incoming calls to effectively address eligibility,...
-
Customer Service Rep I
1 week ago
Norfolk, United States Sentara Healthcare Full timeCity/State Norfolk, VA Overview Work Shift First (Days) (United States of America) Sentara Health is currently recruiting for an In-Person, Full-Time Day Shift Customer Service Rep I in Norfolk, VA. For the Billing Support Services at Sentara Patient Accounting The Customer Service Representative is primarily responsible for handling incoming calls to...
-
Customer Service Rep I
1 week ago
Norfolk, United States Sentara Healthcare Full timeCity/State Norfolk, VA Overview Work Shift First (Days) (United States of America) Sentara Health is currently recruiting for an In-Person, Full-Time Day Shift Customer Service Rep I in Norfolk, VA. For the Consolidated Medical Group department at Sentara Patient Accounting Primarily responsible for handling incoming calls to effectively address eligibility,...
-
Audi - F&I Manager
3 weeks ago
Norfolk, United States Mills Auto Group Full timeMills Auto Group is looking for experienced F&I Managers with extensive luxury experience to join our high volume luxury store Our Automotive Group is looking for high performing Finance Managers. This position requires a high focus on exceptional customer experience while delivering a world class luxury automotive buying experience. We are a 20 year old...
-
Utilization Management Representative
4 weeks ago
Norfolk, Virginia, United States ICONMA Full timeJob Summary:As a Utilization Management Representative at ICONMA, you will play a crucial role in coordinating cases for precertification and prior authorization review. This position requires strong analytical and communication skills to determine contract and benefit eligibility, provide authorization for inpatient admission, outpatient precertification,...
-
Hyundai/Genesis - F&I Manager
3 weeks ago
Norfolk, United States Mills Auto Group Full timeMills Auto Group is GROWING and looking for F&I Managers to join our group. We are growing in several markets! Our automotive group is looking for high performing Finance Managers. We are a 20 year old privately held auto group that is growing and promoting from within so these are coveted spots. We have several brand new locations opening up soon in both...
-
Data and Administrative Support Specialist
4 weeks ago
Norfolk, Virginia, United States i-Mazing Solutions, Inc. Full timeJob Title: Data and Administrative Support Specialisti-Mazing Solutions, Inc. is seeking a highly motivated and qualified professional to provide support for training to the United States Navy. The selected candidate will play a critical role in ensuring military and civilian employees maintain the highest training posture available.Key Responsibilities:•...
-
Pipefitter I
1 week ago
Norfolk, Virginia, United States Delphinus Engineering Full timeJob Summary: Delphinus Engineering seeks a skilled Pipefitter I to provide support to the US Navy in Norfolk, VA. Key Responsibilities:• Fabricate, install, remove, modify, and repair piping and hoses.• Layout, template, and target pipe for welding/brazing in P2 and P3 piping systems.• Maintain steam plant cleanliness and utilize precision measuring...
-
Fleet Manager
1 month ago
Norfolk, Virginia, United States Waste Management Full timeAbout the JobWaste Management is seeking a highly skilled and experienced Sr District Fleet Manager to join our team. As a key member of our operations team, you will be responsible for managing the full fleet of primary and secondary equipment within the assigned area, ensuring safe and reliable vehicles are available to meet operational requirements.Key...
-
Nurse Case Manager I
4 weeks ago
Norfolk, Virginia, United States Elevance Health Full timeJob SummaryWe are seeking a skilled Nurse Case Manager I to join our team at Elevance Health. This role is responsible for providing care management services to members with complex and chronic care needs.Key ResponsibilitiesAssess and develop individualized care plans to address member health needsCoordinate internal and external resources to meet...
-
Sr District Fleet Manager
5 months ago
Norfolk, United States Waste Management Full timeAs an EEO/Affirmative Action Employer, all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, age, national origin, disability, or veteran status. Waste Management (WM), a Fortune 250 company, is the leading provider of comprehensive waste and environmental...
-
Sweeper Operator I
3 weeks ago
Norfolk, United States City of Norfolk, VA Full timeCITY OF NORFOLK: Department of Public Works is currently seeking a Sweeper Operator I within the Division of Environmental Storm Water Management. Sweeper Operator I positions are responsible for operating heavy construction equipment such as street Operator, Sweeper, Vehicle, Equipment, Operations, Manufacturing, Water
-
Sweeper Operator I
4 weeks ago
Norfolk, United States City of Norfolk, VA Full timeCITY OF NORFOLK: Department of Public Works is currently seeking a Sweeper Operator I within the Division of Environmental Storm Water Management. Sweeper Operator I positions are responsible for operating heavy construction equipment such as street Operator, Sweeper, Vehicle, Equipment, Operations, Manufacturing, Water
-
Store Manager
3 weeks ago
Norfolk, United States Hibbett Retail, Inc. Full time01138 Norfolk, NE LE_301 Hibbett Retail, Inc. Job Title: Store Manager Department: Operations FLSA Status: Non-Exempt Reports To: District Sales Manager SUMMARY The Store Manager oversees and is responsible for the store's sales efforts in each department in the store and supervises the store's overall operation to ensure efficiency and profitability....
-
Territory Account Manager
3 weeks ago
Norfolk, United States Red Frog Solutions Full timeJob DescriptionThe Territory Account Manager works directly with representatives, contractors, and other external and internal stakeholders to maximize sales volume. This is an individual contributor role with 50% travel within assigned territory.The territory includes TN, KY, WI, MN, IA, NE, OH, and Chicago metro.This position is more about managing...
-
Territory Account Manager
3 weeks ago
Norfolk, United States Red Frog Solutions Full timeJob DescriptionThe Territory Account Manager works directly with representatives, contractors, and other external and internal stakeholders to maximize sales volume. This is an individual contributor role with 50% travel within assigned territory.The territory includes TN, KY, WI, MN, IA, NE, OH, and Chicago metro.This position is more about managing...
-
Territory Account Manager
3 weeks ago
Norfolk, United States Red Frog Solutions Full timeJob Description The Territory Account Manager works directly with representatives, contractors, and other external and internal stakeholders to maximize sales volume. This is an individual contributor role with 50% travel within assigned territory. The territory includes TN, KY, WI, MN, IA, NE, OH, and Chicago metro. This position is more about managing...