Job Description
Our client, a Health Insurance company, is looking for a Managed Care Coordinator for their Remote location. Responsibilities:
+ This position supports the Health Services and Utilization Management functions and acts as a liaison between Members, Physicians, Delegates, Operational Business members and Member Service Coordinators.
+ Performs review of service requests for completeness of information, collection and transfer of non-clinical data, and acquisition of structured clinical data from physicians/patients.
+ Handles initial screening for pre-certification requests from physicians/members via incoming calls or correspondence based on scripts and workflows, and under the oversight of clinical staff.
+ Prepare, document and route cases in appropriate system for clinical review.
+ Initiates call backs and correspondence to members and providers to coordinate and clarify benefits.
+ Upon completion of inquiries initiat...
+ This position supports the Health Services and Utilization Management functions and acts as a liaison between Members, Physicians, Delegates, Operational Business members and Member Service Coordinators.
+ Performs review of service requests for completeness of information, collection and transfer of non-clinical data, and acquisition of structured clinical data from physicians/patients.
+ Handles initial screening for pre-certification requests from physicians/members via incoming calls or correspondence based on scripts and workflows, and under the oversight of clinical staff.
+ Prepare, document and route cases in appropriate system for clinical review.
+ Initiates call backs and correspondence to members and providers to coordinate and clarify benefits.
+ Upon completion of inquiries initiat...