Utilization Management Assistant
Texas Children's Medical Center•Bellaire, TX
About The Position
We are searching for a Utilization Management Assistant. This role involves receiving, processing, and completing data entry of demographic information on all referral/authorization requests from participating providers via fax or phone. The assistant will also support and collaborate with all medical management staff, as well as other health plan staff, such as the Claims Department and Network Development. Additionally, this position provides customer service and education for all incoming calls regarding provider and/or product information.
Requirements
- H.S. Diploma or GED required
- 2 years managed care, preferably in medical management department, claims and member service preferred
- Experience in Healthcare or Insurance environment preferred
Nice To Haves
- Managed care, preferably in medical management department, claims and member service background helpful.
- Health care setting employment a plus.
Responsibilities
- Serves as support to Medical Management Intake Department
- Eligibility Confirmation
- Provider/Member Education
- Internal Collaboration
- Utilizes resources available from TCHP or State Agencies
- Reference may be made by phone or online
- Dates must be referenced prior to authorizations
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What This Job Offers
Career Level
Entry Level
Education Level
High school or GED
