Job Openings in Sacramento County and Beyond
Responsibilities: Analyze and interpret medical guidelines to determine if appropriate information has been provided in utilization reviews prior to transmission to commercial external payers. Communicate via email, voicemail, regular mail, fax or phone to route Payer Requests. Audit all utilization reviews for missing or incorrect information. Correct or escalate them to a care coordinationspecialist, clinical support nurse, or care coordination supervisor. Provide support to the care coordination department. Retrieve, interpret, and relay any messages in a format that can be stored in a database for processing. Provide excellent customer service to internal and external customers. Answer the department queue line. Compile, produce, and distribute operational reports. Process high volume of data from spreadsheets and databases. Other duties as assigned.
Requirements: 3+ year's coordinating or administrative experience in a healthcare setting. High School Diploma or equivalent required; education or certification in healthcare desired. Excellent Customer Service skills. Proficient with Microsoft Professional Office Suite including Word, Excel & Outlook. Familiar with Medical Terminology, Anatomy, and Physiology. Courteous and professional demeanor. Ability to be flexible with job duties to assist with varying business needs. Strong verbal and written communication skills. High attention to detail. Ability to use sound judgement.