[Hiring] Long Term Services & Support Utilization Management Technician @Amerihealth Caritas

Role Description

Under the direction of the Long-Term Services and Supports (LTSS) Supervisor, the LTSS UM Tech will:

• Coordinate, generate and track both incoming and outgoing correspondence, faxes and authorizations related to prospective, concurrent, and post service review functions.
• Interact with providers, service coordinators, and LTSS UM staff to facilitate receipt of information, and/or records for prompt review and response.
• Provide telephonic verbal notification to participants to maintain UM compliance under the CHC Final Agreement.
• Perform data entry of authorizations to ensure authorizations are provided timely and accurately.
• Perform data entry and maintain operational reports.
• Work with providers to correct authorization to claim issues.
• Perform and remain knowledgeable in all workflow and timeliness requirements for all areas in Utilization Management.

Qualifications

• High School Diploma or GED required.
• Minimum 1 year general office and/or customer service experience required.
• Work experience in healthcare setting required.
• Knowledge of medical terminology required.
• 1 to 3 years General Office or Customer Service experience.

Requirements

• Proficiency with Microsoft Office Suite (Word, Excel, PowerPoint, Teams, One Note).
• Advanced Excel skills is a plus.
• Consistent word processing speed and accuracy of 50 or more words per minute.
• Proficiency with telephonic communications and speaking with participants.
• Proficient working on a computer all day with electronic records.

Benefits

• Flexible work solutions including remote options, hybrid work schedules.
• Competitive pay.
• Paid time off including holidays and volunteer events.
• Health insurance coverage for you and your dependents on Day 1.
• 401(k).
• Tuition reimbursement and more.