Handling initial requests for services, gathering necessary information, and communicating with relevant parties.
Assisting with the prior authorization process by gathering information, preparing documentation, and tracking requests.
Maintaining and organizing patient records, ensuring accurate and up-to-date information is available for reviews.
Facilitating communication between healthcare providers, patients, and other stakeholders regarding UM processes.
Accurately entering data into systems, generating reports, and tracking key performance indicators related to UM activities.
Managing the generation and distribution of various letters related to UM decisions and processes.
Providing general administrative support to the UM team, including scheduling meetings, managing calendars, and preparing presentations.

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
Preferred Qualifications
Proficient utilizing electronic medical record and documentation programs
Proficient and/or experience with medical terminology and/or ICD-10 codes
Bachelor's Degree in Business, Finance or a related field
Prior member service or customer service telephone experience desired
Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization

medical, dental and vision benefits
401(k) retirement savings plan
time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
short-term and long-term disability
life insurance

Administration Coordinator II

Key skills