POSITION SUMMARY RESPONSIBILITIES
Is the first point of contact for all telephone calls to the UM area. Determines member and provider eligibility status of telephonic and faxed authorization requests. Provides administrative and technical support for utilization and case management activity in the UM systems/databases. Reviews pended authorization reports and updates to completion in a timely manner.
EDUCATION/EXPERIENCE
A high school diploma or equivalent experience is required. College or commercial school courses in business functions are preferred. Must be computer literate and possess data entry and typing skills as well as accuracy in administrative duties. Three or more years of recent customer service experience, preferably in a managed care setting is required. Working knowledge of medical terminology, customer service standards, and call center standards is required.
