Coordinator, UM Intake

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

📋 Description

• Act as the primary contact for processing prior authorization requests in line with departmental policies, regulatory standards, and client contractual obligations.

• Analyze internal processes and policies to ascertain whether submitted requests necessitate a prior authorization review or need to be redirected as appropriate.

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

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

• Submit IT tickets to resolve barriers encountered in generating cases for clinical review and ensure the tickets are followed through to resolution.

• Respond to requests in a timely and courteous manner, honoring commitments, and demonstrating persistence in gathering necessary information to resolve issues and challenges.

• Achieve the established Utilization Management Intake Objectives and Key Results.

⛳️ Requirements

• A high school diploma or GED - Required

• 1 – 3 years of experience in a Coordinator role involving the request or submission of prior authorization requests.

• Previous experience or background in Oncology.

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

• Capacity to adjust to changing situations and perform detailed work while minimizing errors. - Required

• Competent in using computer applications and Windows PC systems, including strong keyboard and navigation skills. - Required

• Team-oriented, exhibiting a robust work ethic and a commitment to productivity. - Required

• Proven ability to achieve established goals while managing a workload and prioritizing tasks in a remote setting. - Required

🏝️ Benefits

• Health insurance benefits