Hybrid Utilization Management Administration Coordinator – Phone Intake

at CenterWell Senior Primary Care

• Job title: Utilization Management Administration Coordinator – Phone Intake
• Job type: Full Time
• Experience level: Junior
• Salary: $40,000 - $52,300 per year
• Degree requirement: Bachelor's Degree
• Location requirements: Hybrid, United States

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