Coordinator, UM Intake

This is a fully remote position, open to applicants in California.

📋 Description

• Act as the primary contact for managing prior authorization requests in line with departmental guidelines, regulatory standards, and client agreements.

• Assessing internal workflows and policies to ascertain whether submitted requests necessitate a prior authorization review or need to be redirected accordingly.

• Inputting data into a proprietary system to create cases for both medical and behavioral health reviewers.

• Collaborating directly with physician offices to gather any missing information essential for submitting a prior authorization request.

• Submitting IT tickets to resolve obstacles in generating cases for clinical review and tracking the ticket until completion.

• Responding to requests in a timely and courteous manner, fulfilling commitments, and demonstrating persistence in acquiring the necessary information to resolve issues.

• Achieving set Utilization Management Intake Objectives and Key Results.

⛳️ Requirements

• A high school diploma or GED - Required

• 1 – 3 years of experience in a Coordinator role focused on requesting or submitting prior authorization requests, or relevant healthcare experience in claims or appeals and grievances - Required

• Prior experience in Oncology is preferred.

• Proficient in reading, writing, and speaking English fluently with patients and providers - Required

• Capable of adapting to changing situations and performing detailed work while minimizing errors - Required

• Skilled in using computer applications and Windows PC, demonstrating strong keyboard and navigation abilities - Required

• Team-oriented, showcasing a strong work ethic and dedication to productivity - Required

• Proven ability to meet established targets while managing workload and prioritizing tasks in a remote setting - Required

🏝️ Benefits

• Health insurance benefits