Review Coordinator

Medica

15h • Remote

About The Position

Medica is a nonprofit health plan with more than a million members that serves
communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver
personalized health care experiences and partner closely with providers to
ensure members are genuinely cared for.

We're a team that owns our work with accountability, makes data-driven
decisions, embraces continuous learning, and celebrates collaboration — because
success is a team sport. It's our mission to be there in the moments that matter
most for our members and employees. Join us in creating a community of connected
care, where coordinated, quality service is the norm and every member feels
valued.

Medica’s Review Coordinator is responsible for coordinating and supporting all
intake functions within the Utilization Management Department, in accordance
with departmental policies, regulatory requirements, and accreditation
standards. Performs other duties as assigned.

This is a critical role at Medica, as downstream activities, depend upon the
timely, accurate processing of information to perform their job functions.

Requirements

• High School Diploma or Equivalent; Associate’s or Bachelor’s degree preferred
• 2+ years of healthcare industry experience within a professional customer service or related experience

Nice To Haves

• Knowledge of prior authorization or hospital admission processes preferred, however not required
• Advanced data entry skills
• Strong verbal and written communication
• Strong organizational and time management skills
• Ability to manage multiple tasks and priorities
• Analytical and critical thinking skills
• Ability to work with limited supervision
• Attention to detail and accuracy are critical
• Excellent computer skills

Responsibilities

• Triage, research and enter acute inpatient hospital admissions and outpatient medical prior authorization requests
• Triage, research and enter member administrative referrals
• Triage, research and complete non-clinical service requests
• Outreach attempts to providers requesting clinical or additional information needed for the requested reviews
• Research and resolution of provider and member questions and issues while maintaining a positive customer relationship

Benefits

• competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED