Description:
We are looking for a utilization management representative to join our team. This position is a remote role but you must live within 50 miles of Indianapolis, IN to be eligible. This role is Monday - Friday 8am- 5pm EST and the pay for this role is $18.00/hr.
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Responsible for coordinating cases for precertification and prior authorization review
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Managing incoming calls or incoming post services claims work.
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Determines contract and benefit eligibility
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Provides authorization for inpatient admission, outpatient certification, and post service requests
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Refers cases requiring clinical review to a nurse reviewer
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Responsible for the identification and data entry of referral requests into the UM system
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Responds to telephone and written inquiries from clients, providers and in-house departments
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Other duties as assigned
Requirements:
Requires:
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HS Diploma/GED
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Minimum 1 year of customer service experience or call-center experience or any combination of education and experience
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Medical terminology training and experience in the medical or insurance field is preferred
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Needs to have strong oral, written and interpersonal communication skills, problem-solving skills, and analytical skills