Analyst managing billing and operational control in a hybrid work setup at telecommunications firm in Chile. Handling invoices, payment reports, and project management tasks.
CC
Hybrid Utilization Management Administration Coordinator – Phone Intake
Posted 2 months ago
About the role
- Utilization Management Administrative Coordinator providing high-quality support to healthcare providers. Responsibilities include handling calls for referral authorizations and processing inquiries per UM protocols and policies.
Responsibilities
- Provide high-quality support to healthcare providers contacting the call center
- Respond promptly and professionally to incoming calls from providers
- Accurately gather, verify, and enter provider and member information into the appropriate systems
- Review and process referral authorization requests according to established UM protocols and regulatory requirements
- Collaborate with clinical and administrative staff to resolve issues
- Provide clear and courteous information regarding UM processes
- Monitor call queues and manage multiple tasks to maintain service level agreements
- Identify and escalate complex or urgent cases to the appropriate clinical or supervisory staff as needed
- Maintain thorough documentation of all interactions
Requirements
- 1 or more years administrative or technical support experience
- Excellent verbal and written communication skills
- Working knowledge of MS Office including Word, Excel, and Outlook in a Windows based environment
- Must have accessibility to high speed DSL or Cable modem for a home office (Satellite internet service is NOT allowed for this role); recommended speed is 10Mx1M
- Proficient utilizing electronic medical record and documentation programs
- Proficient and/or experience with medical terminology and/or ICD-10 codes
- Bachelor's Degree in Business, Finance or a related field
- Prior member service or customer service telephone experience desired
- Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization
Benefits
- medical, dental and vision benefits
- 401(k) retirement savings plan
- time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
- short-term and long-term disability
- life insurance and many other opportunities
Job title
Job type
Experience level
Salary
Degree requirement
Location requirements
Senior Claims Administrator managing and negotiating pre - authorization and Letter of Guarantee requests. Reviewing medical admissions and ensuring adherence to policy terms and conditions while providing stakeholder updates.
Vice President of Business Administration leading strategic programs and business administration for Care organization. Collaborating with leadership and managing large initiatives for operational effectiveness.
Sales Administrator supporting sales operations in a hybrid role at Tantalus Systems. Coordinating activities across teams to enhance sales effectiveness and operational discipline.
Identity & Access Administrator managing client identity environments at Centorrino Technologies. Focusing on identity administration, automation, and audit remediation across Microsoft Entra ID and Active Directory.
Product administration technician supporting Desjardins components and administering specialized products. Involves research, analysis, and preparing reports.
Sales Support Administrator assisting Supermicro's field sales team by processing orders and monitoring inventory. Responding to inquiries and generating sales reports.
Information Administrator managing operational data for Cemex USA. Ensuring operational processes run effectively and supporting various departments.
Information Administrator overseeing operational data and systems at Cemex USA. Ensuring compliance, data integrity, and supporting plant operations with SAP systems.
Information Administrator responsible for the governance of operational data and systems at Cemex USA. Ensuring efficient plant operations and compliance through effective data management.