Utilization Management Coordinator
Core
Provide non-clinical support for policies and procedures ensuring best and appropriate treatment, care, or services for members by processing prior authorization requests.
Role type
Utilization Management Coordinator
Builds
Prior authorization workflows and documentation for Humana's Wisconsin Medicaid Market
Domain
Health insurance / Medicaid
Required skills
Prior authorization processing, Microsoft Office (Word, Excel, PowerPoint), inbound/outbound customer service, data entry, multi-tasking
Preferred skills
Prior authorization or utilization management experience, health insurance environment experience, residency in Wisconsin
Technologies
TruCare, Microsoft Office
Responsibilities
Process and document incoming inpatient and outpatient prior authorization requests, contact providers for clarification, conduct inbound and outbound calls regarding PA status, enter requests into the prior authorization database, prepare documentation for clinical review
Seniority
Entry-level to Junior