Healthcare Service Management Associate
3 days ago
Estimated Salary: $58,000 - $68,000 per year
About Us: Fallon Health is committed to delivering high-quality, patient-centered care. Our team is dedicated to working collaboratively with our patients, providers, and partners to improve health outcomes and inspire hope.
Job Description:
- We are seeking a highly motivated and detail-oriented Healthcare Service Management Associate to join our team. The successful candidate will work closely with our authorization coordinators to ensure efficient and effective processing of medical authorizations.
- As a Healthcare Service Management Associate, you will be responsible for managing the authorization process, communicating with providers and patients, and resolving complex issues.
- You will also be handling incoming calls from multiple ACD lines, addressing customer inquiries, and providing direction regarding plan policies and procedures.
- The ideal candidate will have excellent communication and problem-solving skills, with the ability to maintain high levels of confidentiality and professionalism.
Key Responsibilities:
- Manages the authorization process, including initiating entry of request(s) into core system (QNXT/TruCare) and case management application (TruCare) as applicable.
- Handles an appropriately high volume of daily auth entries into the core system (QNXT).
- Prepares completed authorization records for filing in accordance with company record retention policy.
- Assists with departmental auto fax process, including running error reports and missing Fax # report on a daily basis as assigned.
- Interfaces with other FCHP departments to obtain and verify information relevant to pre-authorization requests.
Qualifications:
- Bachelor's degree or equivalent experience in healthcare administration or a related field.
- At least 2 years of experience in a managed healthcare environment, preferably in a call center setting.
- Excellent communication, problem-solving, and time management skills.
- Able to maintain high levels of confidentiality and professionalism.
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