UM Review Coordinator II
Medica•,
•$41,300 - $61,950•Remote
About The Position
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
- 2+ years of healthcare industry experience within a professional customer service or related experience
- Eligibility to work in the US
Nice To Haves
- Associate’s or Bachelor’s degree preferred
- 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
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
