[Remote] Healthcare Utilization Management Intake Analyst
Note: The job is a remote job and is open to candidates in USA. UST HealthProof is a trusted partner for health plans, offering an integrated ecosystem for health plan operations. The Healthcare Utilization Management Intake Analyst will support coordination of medical services including utilization management intake, requesting medical records, and provider requests to promote effective utilization of healthcare services.
Responsibilities
- Provide support services to team members by answering incoming telephone calls, taking messages, researching information and building authorizations in the UM system
- Requesting medical records for pending authorizations or continued stay authorizations
- Generate UM letters for members and providers when authorizations are not required
- Refers to needed services in accordance to benefit plan
- Maintain accurate and complete documentation of required information that meets quality standards
- Protect the confidentiality of the member information and adheres to the company policies regarding confidentiality
Skills
- High school diploma or G.E.D. required
- Experience with medical terminology and concepts used in the healthcare delivery system, provider office, or the insurance industry is required
- Computer literacy to include Microsoft Office products
- Advanced technical skills for use of hardware and software with a high degree of accuracy
- Excellent oral and written communication skills for representation of clear and concise results
- Ability to manage significant workload, and to work efficiently under pressure, meeting established deadlines with minimal supervision
- Strong time management skills
- Must possess high degree of accuracy, efficiency, and dependability
- Strong customer service skills to assist members and/or providers with understanding healthcare information and to coordinate issue resolution
- Effective written and verbal communication and feedback
- Effective organizational skills with ability to be flexible and prioritize tasks
- Must be knowledgeable of and able to use standard, basic grammar, punctuation, and spelling
- Associate or bachelor s degree in health care related field is preferred
- Current unrestricted LPN license or certified Medical Assistant designation preferred
- Minimum of one year experience in a health care related field. Preferred setting is hospital, medical doctor s office, or health insurance company
Benefits
- Full-time, regular employees accrue up to 16 days of paid vacation per year
- Receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year)
- 10 paid holidays
- Eligible for paid bereavement leave
- Eligible to participate in the Company’s 401(k) Retirement Plan with employer matching
- Eligible for medical, dental, and vision insurance
- Basic life insurance
- Accidental death and disability insurance
- Short- and long-term disability benefits
- Purchase additional voluntary short-term disability benefits
- Participate in a Health Savings Account (HSA)
- Flexible Spending Account (FSA) for healthcare, dependent child care, and/or commuting expenses
- Potential for quarterly incentive-based bonuses and or commissions depending on role
Company Overview
Company H1B Sponsorship