AmeriHealth Caritas
Long Term Services & Support Utilization Management Technician
This job is now closed
Job Description
- Req#: 28889
- Coordinate, generate and track both incoming and outgoing correspondence, faxes and authorizations related to prospective, concurrent and post service review functions.
- Interacts with providers and LTSS UM staff to facilitate receipt of information, and /or records for prompt review and response.
- Provides verbal notification to participants to maintain UM compliance under the CHC Final Agreement.
- Performs data entry of authorizations to ensure authorizations are provided timely and accurately.
- Performs data entry and maintains operational reports.
- Works with Providers to correct authorization to claim issues.
- Performs and remains knowledgeable in all workflow and timeliness requirements for all areas in Utilization Management.
- High School/GED.
- Minimum 1 year general office and/or customer service experience required.
- Work experience in healthcare setting required.
- Knowledge of medical terminology required.
- 1 to 3 years General Office or Customer Service Experience.
- Proficiency with Microsoft Office Suite (Word, Excel, Power Point). Access is a plus. Consistent word processing speed and accuracy of 50 or more words per minute.
Responsibilities:
Under the direction of the Long Term Services and Supports (LTSS) Supervisor, the LTSS UM Tech will:
Education/ Experience:
Other Skills:
About the company
AmeriHealth Caritas is a different kind of health care company. Our goal is to provide responsible managed care solutions, including Medicaid, Medicare, and CHIP — plus pharmacy benefit management, behavioral health, and administrative services.
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