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Lumen Solutions Group Inc. · 2 days ago

Coord, Utilization Mgmt I

United States

Full-time

Remote

Entry Level

$24/hr - $24/hr

3+ years exp

Lumen Solutions Group Inc. is a company focused on providing support in the healthcare sector, and they are seeking a Coordinator for Utilization Management. The role involves assisting the clinical teams with non-clinical administrative tasks, including authorization management, claims inquiries, and general departmental support.

Information Technology & Services

Growth Opportunities

Responsibilities

Performs member or provider related administrative support which may include benefit verification, authorization creation and management, claims inquiries and case documentation

Reviews authorization requests for initial determination and/or triages for clinical review and resolution

Provides general support and coordination services for the department including but not limited to answering and responding to telephone calls, taking messages, letters and correspondence, researching information and assisting in solving problems

Assists with reporting, data tracking, gathering, organization and dissemination of information such as Continuity of Care process and tracking of Peer to Peer reviews

Qualification

Authorization experienceCPTICD-10 codingHealth care experienceWeb-based technologyCustomer service skillsAnalytical skillsReliability/DependabilityCommunication skillsOrganizational skillsAttention to detail

Required

High School Diploma

3 years experience in health care claims/service areas or office support

Ability to effectively participate in a multi-disciplinary team including internal and external participants

Excellent communication, organizational and customer service skills

Knowledge of basic medical terminology and concepts used in managed care

Knowledge of standardized processes and procedures for evaluating medical support operations business practices

Excellent independent judgment and decision-making skills, consistently demonstrating tact and diplomacy

Ability to pay attention to the minute details of a project or task

Experienced in the use of web-based technology and Microsoft Office applications such as Word, Excel, and Power Point

Must be able to effectively work in a fast-paced environment with frequently changing priorities, deadlines, and workloads that can be variable for long periods of time

Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence

Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging

Previous authorization experience

Strong analytical skills

Good communication skills

Electronic efficiency

Reliability/Dependability