Duties & Responsibilities:

* 85% - Medical Authorization
* Receives referral requests via fax, phone or electronically and enters new service request information into the authorization system.
* Collects additional information from Health members and providers to complete referral information.
* Authorizes requested services according to Health’s authorization guidelines, performing data entry into the authorization system and verifying eligibility.
* Contacts the health networks and Health Customer Service regarding health network enrollments.
* Assists the Medical Case Managers in gathering medical records, obtains appropriate coding for diagnosis and procedures and follows up on phone calls as directed by the authorization nurse.
* Documents all contacts and case information in the system using the standard charting format.
* Performs data entry into the appropriate databases for monitoring, tracking and trending of events and other relevant databases as needed.

* 10% - Administrative Support
* Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
* Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.

* 5% - Other
* Completes other projects and duties as assigned.

Minimum Qualifications:

* High School diploma or equivalent required.

* 2 years of experience in a health care or managed care setting required.

* An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.

Preferred Qualifications:

* Bilingual in English and in one of Health's defined threshold languages (Arabic, Chinese, Farsi, Korean, Spanish, Vietnamese).

* Prior authorization and utilization management process experience.

Job Types: Full-time, Contract

Pay: $22.00 - $24.00 per hour

Expected hours: 40 per week

Benefits:

• Dental insurance
• Health insurance
• Vision insurance

Schedule:

• 8 hour shift

Work setting:

• In-person
• Office

Experience:

• health care or managed care setting required.: 2 years (Required)

Work Location: In person