Prior Authorization UM Coordinator - Remote

Overview

The Prior Authorization UM Coordinator provides essential non-clinical support to ensure appropriate treatment and care for members while collaborating with various healthcare professionals.

In Short

• Support Utilization Management Nurses in processing discharge orders.
• Document calls and requests regarding healthcare services.
• Process incoming fax/email requests for services daily.
• Communicate with healthcare providers and facilities effectively.
• Assist in various clerical and administrative tasks.
• Participate in special projects as assigned.
• Work Monday-Friday from 8am-5pm EST, with occasional weekend shifts.
• Utilize Microsoft Office tools for documentation and communication.
• Handle provider and member correspondence efficiently.
• Work remotely with specific internet requirements.

Requirements

• 1+ years of experience in Utilization Review and/or Prior Authorization.
• 1+ years of experience in the Healthcare field.
• Proficiency in Microsoft Word, Excel, and Outlook.
• Knowledge of Medicare and Medicaid guidelines.
• Bilingual in English and Spanish preferred.
• Experience with documentation programs and medical terminology.
• Ability to work in a fast-paced environment.
• Strong communication skills.
• Ability to work independently and as part of a team.
• Must reside in CST or EST states.

Benefits

• Comprehensive medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Generous paid time off and holidays.
• Short-term and long-term disability insurance.
• Life insurance and additional benefits.
• Support for personal wellness and healthcare decisions.
• Opportunities for professional development.
• Flexible work environment with remote options.
• Internet expense reimbursement for certain states.
• Equal opportunity employer commitment.