Three Point Solutions
Utilization Mgmt. Coord. I
Three Point Solutions, Baltimore, Maryland, United States, 21276
Job Title: Utilization Mgmt. Coord. I
Client: Health Care Industry
Duration: 3 Months
Location: Baltimore, MD 21224
Purpose:Support Utilization Management clinical teams with non-clinical administrative tasks related to pre-service, utilization review, care coordination, and quality of care.Essential Functions:
35% Perform member or provider related administrative support (e.g., benefit verification, authorization management, claims inquiries).35% Review authorization requests and triage for clinical review.20% Provide general departmental support (e.g., answering calls, correspondence, research, problem-solving).10% Assist with reporting, data tracking, and organization of information (e.g., Continuity of Care, Peer to Peer reviews).Qualifications:
Education Level: High School DiplomaExperience: 3 years in health care claims/service areas or office support.Preferred Qualifications:
2 years in health care/managed care setting or divisional experience.Knowledge of CPT and ICD-10 coding.Knowledge, Skills, and Abilities (KSAs):
Ability to participate effectively in multi-disciplinary teams.Excellent communication, organizational, and customer service skills.Knowledge of basic medical terminology and managed care concepts.Familiarity with standardized processes for evaluating medical support operations.Strong independent judgment, decision-making, tact, and diplomacy.Attention to detail.Proficient in web-based technology and Microsoft Office applications (Word, Excel, PowerPoint).Additional Requirements:
Must disclose any debarment, exclusion, or other eligibility events related to Federal health care programs.Ability to work in a fast-paced environment with changing priorities and deadlines.Effective handling of multiple customer service demands with a focus on service excellence.Strong communication and customer service skills, even with challenging customers.
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Client: Health Care Industry
Duration: 3 Months
Location: Baltimore, MD 21224
Purpose:Support Utilization Management clinical teams with non-clinical administrative tasks related to pre-service, utilization review, care coordination, and quality of care.Essential Functions:
35% Perform member or provider related administrative support (e.g., benefit verification, authorization management, claims inquiries).35% Review authorization requests and triage for clinical review.20% Provide general departmental support (e.g., answering calls, correspondence, research, problem-solving).10% Assist with reporting, data tracking, and organization of information (e.g., Continuity of Care, Peer to Peer reviews).Qualifications:
Education Level: High School DiplomaExperience: 3 years in health care claims/service areas or office support.Preferred Qualifications:
2 years in health care/managed care setting or divisional experience.Knowledge of CPT and ICD-10 coding.Knowledge, Skills, and Abilities (KSAs):
Ability to participate effectively in multi-disciplinary teams.Excellent communication, organizational, and customer service skills.Knowledge of basic medical terminology and managed care concepts.Familiarity with standardized processes for evaluating medical support operations.Strong independent judgment, decision-making, tact, and diplomacy.Attention to detail.Proficient in web-based technology and Microsoft Office applications (Word, Excel, PowerPoint).Additional Requirements:
Must disclose any debarment, exclusion, or other eligibility events related to Federal health care programs.Ability to work in a fast-paced environment with changing priorities and deadlines.Effective handling of multiple customer service demands with a focus on service excellence.Strong communication and customer service skills, even with challenging customers.
#ZR