Administrator – In Training
PACS
Utilization Management Administration Coordinator - Phone Intake
CenterWell Senior Primary Care
full-time
Posted on:
Location: Florida • 🇺🇸 United States
Visit company websiteSalary
💰 $40,000 - $52,300 per year
Job Level
Junior
About the role
- Provide high-quality support to healthcare providers contacting the call center to initiate referral authorizations or check the status of existing requests
- Serve as a key liaison between providers and internal UM teams, ensuring timely and accurate processing of referral and authorization inquiries in accordance with organizational policies and regulatory guidelines
- Provide non-clinical support for the policies and procedures ensuring best and most appropriate treatment, care or services for members
- Respond promptly and professionally to incoming calls from providers seeking to initiate referral authorizations or obtain status updates on existing requests
- Accurately gather, verify, and enter provider and member information into the appropriate systems
- Review and process referral authorization requests according to established UM protocols, policies, and regulatory requirements
- Collaborate with clinical and administrative staff to resolve issues, clarify requirements, and ensure efficient case management
- Provide clear, concise, and courteous information regarding UM processes, documentation requirements, and referral guidelines
- Monitor call queues and manage multiple tasks to maintain service level agreements and minimize provider wait times
- Identify and escalate complex or urgent cases to the appropriate clinical or supervisory staff as needed
- Maintain thorough documentation of all interactions and transactions in accordance with company standards
- Participate in ongoing training and quality assurance activities to maintain up-to-date knowledge of UM policies and procedures
- Adhere to all applicable privacy, confidentiality, and compliance regulations
Requirements
- 1 or more years administrative or technical support experience
- Excellent verbal and written communication skills
- Working knowledge of MS Office including Word, Excel, and Outlook in a Windows based environment and an ability to quickly learn new systems
- Must have accessibility to high speed DSL or Cable modem for a home office (Satellite internet service is NOT allowed for this role); recommended speed is 10Mx1M
- Must be passionate about contributing to an organization focused on continuously improving consumer experiences
