Job description
Job Duties
Manage intake of provider requests through various modes of submission include but not limited to, secure fax, e-form or telephonic requests.
Create UM requests in accordance with Customers policies and procedures and documentation guideline.
Provide current review status updates to requesting provider offices or receipt confirmations.
Provide information regarding clinical information requirements, additional clinical information requests and education on Customers UM processes and requirements to providers.
Provide support to the UM nurses as needed to complete their clinical review requirements.
Perform other duties as assigned by the UM nurses.
Participate in department meetings, training and audit activities equal to Customers employees.
Role/Education Requirements
Minimum of 2 years of recent health plan experience
High level of expertise in UM services
Experience with MCG Criteria (preferred but not required)
Role Details
… Job Type: Contract
Pacific business hours, Monday through Friday
Work Location: Remote
Job Types: Full-time, Contract
Pay: $23 per hour 1099
Expected hours: 40 per week
Schedule:
8 hour shift
Monday to Friday
Experience
Health insurance plan: 2 years (Required)
Work Location: Remote
Job Types: Full-time, Contract
Pay: $23.00 per hour
Expected hours: 40 per week
Schedule:
Monday to Friday
Experience:
Customer service: 1 year (Preferred)
Intake Coordinator-Health Plan: 2 years (Required)
Work Location: Remote
