Provide support services to team members by answering incoming telephone calls, taking messages, researching information and building authorizations in the UM system. Request medical records for pending authorizations or continued stay authorizations Generate UM letters for members and providers when authorizations are not required. Refer to needed services in accordance to benefit plan Maintain accurate and complete documentation of required information that meets quality standards. Protect the confidentiality of the member information and adheres to the company policies regarding confidentiality. Perform other duties as assigned

 

Qualifications:

Associate or bachelor’s degree in health care related field an advantage but not required; high school diploma or G.E.D. required Minimum of one year experience in a health care related field. Preferred setting is hospital, medical doctor’s office, or health insurance company Experience with medical terminology and concepts used in the healthcare delivery system, provider office, or the insurance industry is required Computer literacy including Microsoft Office products Excellent oral and written communication skills for representation of clear and concise results Ability to manage significant workload, and to work efficiently under pressure, meeting established deadlines with minimal supervision Strong time management skills Must possess high degree of accuracy, efficiency, and dependability Strong customer service skills to assist members and/or providers with understanding healthcare information and to coordinate issue resolution Effective written and verbal communication and feedback Effective organizational skills with ability to be flexible and prioritize tasks Must be knowledgeable of and able to use standard, basic grammar, punctuation, and spelling in English Amenable to work nightshift