• Job Description

  Req#: 24817

  Responsibilities:

  The Utilization Management Tech functions under the direction of the Supervisor to coordinate, generate and track both incoming and outgoing correspondence, faxes and authorizations related to prospective, concurrent and post service review functions. Interacts with facilities, vendors, providers, and other staff to facilitate receipt of information, and /or records for prompt review and response. Compensation plans for physicians, licensed nurse reviewers, staff, and consultants who conduct medical management do not contain incentives, directly or indirectly, that encourage barriers to care and service in making determinations.

  Education/Experience:

  • High School/GED.
  • Associate’s Degree Preferred.
  • High School Diploma or GED required.
  • Minimum 1 year general office and/or customer service experience required.
  • Work experience in healthcare setting required.
  • Knowledge of medical terminology required.
  • 1-3 years Managed Care, Insurance, Call Center Experience.
  • 3-5 years Office Experience.
  • Proficiency with Microsoft Office Suite (Word, Excel, Power Point). Consistent word processing speed and accuracy of 50 or more words per minute.

• 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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