Utilization Management Assistant

We are searching for a Utilization Management Assistant- Someone who receives, processes and completes data entry of demographic information on all referral/authorization requests from participating providers via fax or phone. Assists and collaborates with all medical management staff, as well as other health plan staff, e.g. Claims Department, Network Development. Provides customer service and education for all incoming calls regarding provider and/or product information.

Think you've got what it takes?

Qualifications:

• H.S. Diploma or GED required
• 2 years managed care, preferably in medical management department, claims and member service preferred
• Experience in Healthcare or Insurance environment preferred

Responsibilities:

• Serves as support to Medical Management Intake Department
• Eligibility Confirmation
• Provider/Member Education
• Internal Collaboration
• Managed care, preferably in medical management department, claims and member service background helpful. 
• Health care setting employment a plus. 
• Utilizes resources available from TCHP or State Agencies. Reference may be made by phone or online. Dates must be referenced prior to authorizations.