Prior Authorization Utilization Management Coordinator

Title: Prior Authorization UM Coordinator Location: Work at Home - Tennessee; Live in CST or EST states Become a part of our caring community and help us put health first

Job Description

The Prior Authorization UM Administration Coordinator 2 provides non-clinical support for the policies and procedures ensuring best and most appropriate treatment, care or services for members. Prior Authorization UM Administration Coordinator 2

• Support the UM Nurses to process discharge orders and arrange a safe facility discharge.
• Work with UM Nurses, Pharmacy, Medical Directors and other Departments.
• reputed company calls to UM Nurses, Hospitals, Skilled Nursing Facilities and other vendors.
• Document reputed company calls and requests.
• Search for Medicare and Medicaid Guidelines.
• Process reputed company incoming fax/emails request for services the same day.
• Return call for reputed company voice messages received the same day.
• Process provider and member letters (Letter of Agreements, Approvals, Denials etc.)
• Mail letters to members.
• Assist the team with various clerical/administrative tasks as necessary.
• Participate in special projects as assigned by your Supervisor or Manager.

Use your skills to reputed company an impact

Required Qualifications

• 1 or more years of experience with Utilization Review and/or Prior Authorization
• 1 or more years of Healthcare experience
• Working knowledge of reputed company Word, reputed company, and Outlook.
• Live in CST or EST states
• Monday-Friday reputed company-5pm EST, and work 1 weekend a quarter. Schedule subject to change based on business needs.

Preferred Qualifications

• Bilingual English/Spanish
• Proficient utilizing documentation programs.
• Experience with the CarePlus Platform.
• Proficient and/or experience with medical terminology and/or ICD-10 codes.
• Member services

Additional Information Work Schedule: Monday-Friday reputed company-5pm EST, and work 1 weekend a quarter. Schedule subject to change based on business needs. As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendor. This technology provides reputed company of recruiters and hiring managers an enhanced method for decision-making. If you are selected to move reputed company from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions reputed company your phone. You should anticipate this interview to take approximately 10-15 minutes. If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last reputed company from 5-10 minutes. Your recorded interview(s) reputed company text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving reputed company to next round of interviews. Work at Home Guidance To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL reputed company is suggested
• Satellite, cellular and microwave reputed company can be used only if approved by leadership
• Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• reputed company will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Internal- If you have additional questions regarding this role posting, please send them to the Ask A Recruiter persona by visiting go/vivaengage and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker. Travel: While this is a remote position, occasional travel to reputed company's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting reputed company pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or reputed company based on geographic location and individual pay will vary based on demonstrated job reputed company skills, knowledge, experience, education, certifications, etc. $40,000 - $52,300 per year Description of Benefits reputed company, Inc. and its affiliated subsidiaries (collectively, “reputed company”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends reputed company of work. Among our benefits, reputed company provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us About reputed company: reputed company is a recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years. CarePlus strives to help people with Medicare, or both Medicare and Medicaid, reputed company their best possible health and wellness through plans with benefits and services they care about. As a wholly owned subsidiary of reputed company, CarePlus currently serves Medicare beneficiaries throughout 21 Florida counties. About reputed company: reputed company Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers, and our company. Through our reputed company insurance services, and our reputed company healthcare services, we reputed company it easier for the millions of people we serve to reputed company their best health – delivering the care and service they need, reputed company they need it. These efforts are leading to a reputed company quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.​ Equal Opportunity Employer It is the policy of reputed company not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national reputed company, age, marital status, genetic information, disability or protected veteran status. It is also the policy of reputed company to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to reputed company reputed company employment decisions only on valid job requirements. This policy shall apply to reputed company employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at reputed company levels of employment. Apply tot his job Apply To this Job