Job Title: Utilization Mgmt. Coord. I
Client: Health Care Industry
Duration: 3 Months
Location: Owings Mills Maryland 21117
Purpose:
- Support Utilization Management clinical teams with nonclinical administrative tasks related to preservice utilization review care coordination and quality of care.
Essential Functions:
- 35% Perform member or provider related administrative support (e.g. benefit verification authorization management claims inquiries).
- 35% Review authorization requests and triage for clinical review.
- 20% Provide general departmental support (e.g. answering calls correspondence research problemsolving).
- 10% Assist with reporting data tracking and organization of information (e.g. Continuity of Care Peer to Peer reviews).
Qualifications:
- Education Level: High School Diploma
- Experience: 3 years in health care claims/service areas or office support.
Preferred Qualifications:
- 2 years in health care/managed care setting or divisional experience.
- Knowledge of CPT and ICD10 coding.
Knowledge Skills and Abilities (KSAs):
- Ability to participate effectively in multidisciplinary teams.
- Excellent communication organizational and customer service skills.
- Knowledge of basic medical terminology and managed care concepts.
- Familiarity with standardized processes for evaluating medical support operations.
- Strong independent judgment decisionmaking tact and diplomacy.
- Attention to detail.
- Proficient in webbased technology and Microsoft Office applications (Word Excel PowerPoint).
Additional Requirements:
- Must disclose any debarment exclusion or other eligibility events related to Federal health care programs.
- Ability to work in a fastpaced environment with changing priorities and deadlines.
- Effective handling of multiple customer service demands with a focus on service excellence.
- Strong communication and customer service skills even with challenging customers.
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