What are the responsibilities and job description for the Utilization Management Technician position at Ampcus, Inc?
Ampcus Inc. is a certified global provider of a broad range of Technology and Business consulting services. We are in search of a highly motivated candidate to join our talented Team.
Job Title: Utilization Management Technician
Location(s): Los Angeles, CA
Position Overview:
The Utilization Management (UM) Tech plays a vital role in supporting the coordination and processing of prior authorization requests to ensure timely and accurate determination of medical necessity and service eligibility. This position requires strong attention to detail, effective communication skills, and the ability to work efficiently within established clinical and administrative guidelines.
- Receive, review, and process urgent, routine, pre-service, and retro authorization requests.
- Accurately enter and update authorization data in applicable EMR and business systems (EPIC preferred).
- Apply clinical protocols and organizational guidelines to determine approval requirements.
- Identify and resolve missing or incomplete information in authorization requests.
- Collaborate with internal and external stakeholders (providers, members, clinical staff, etc.) to obtain necessary documentation.
- Ensure compliance with departmental policies, regulatory standards, and turnaround time requirements.
- Maintain confidentiality and uphold HIPAA and data privacy standards at all times.
- Previous coordinator experience in a healthcare or managed care setting.
- Health plan experience with exposure to utilization management or prior authorization processes.
- EMR experience required; EPIC system experience strongly preferred.
- Strong analytical, organizational, and problem-solving skills.
- Excellent communication and customer service abilities.
- Ability to work independently in a remote environment while meeting performance expectations.
Ampcus is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veterans or individuals with disabilities.
Ampcus is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identify, national origin, age, protected veterans or individuals with disabilities.