Associate Care Management Coordinator jobs in United States
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Highmark · 13 hours ago

Associate Care Management Coordinator

positionErie-Meadville Area
timeFull-time
remoteOnsite
seniorityNew Grad, Entry Level
money$19.27/hr - $27.42/hr

Highmark Inc. is a healthcare organization seeking an Associate Care Management Coordinator. The role involves processing pre-certification requests for healthcare services, ensuring compliance with regulatory requirements, and maintaining department standards for call volume and response time.

Health CareHealth InsuranceInsuranceWellness

Responsibilities

Communicate effectively
Proactively inform designated individuals of the status of work assignment to assure decision timeframes and notification requirements are met
Communicate effectively with Utilization Management Staff, providers, other internal and external customers and management
Provide accurate and timely routing of service requests to the nurse reviewer to assure that the decision and notification timeframes are in compliance with regulatory guidelines
Process service requests meeting established guidelines, and document and route requests that are not permitted
Request additional information verbally and in writing when the information provided is not adequate to make a medical necessity determination
Adhere to line of business phone standards to assure regulatory requirements are met
Utilize phone functions to monitor the number of calls in queue and wait time
Utilize daily phone standard reports to assess opportunities for self improvement
Meet or exceed standards for other production and quality measures
Other duties as assigned or requested

Qualification

Medical terminologyICD-9 codingCPT codingCustomer serviceTyping skillsComputer skillsCommunicationTeamwork

Preferred

High School Diploma / GED
Experience in customer service
Experience in typing, keyboard and computer skills
Work experience in medical terminology
Associates degree or certification in a health related occupation
Work experience with ICD-9 and/or CPT coding

Company

Highmark

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Highmark provides health insurance plans for individuals and businesses.
dateFounded in 1996
location
Pittsburgh, Pennsylvania, USA
people-size10001+ employees
web-link
https://www.highmark.com

Funding

Current Stage
Late Stage
Total Funding
$27.3M
2018-04-06Grant· $25M
2014-08-07Grant· $2.3M

Leadership Team

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Deborah Rice-Johnson
CEO, Diversified Businesses at Highmark Inc. and Chief Growth Officer
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Paul Sikora
CTO Provider Services
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Recent News

PR Newswire
Highmark Health Reports $24.6 Billion in Revenue, $69 Million Net Loss for the Nine Months ended Sept. 30, 2025; Maintains Growth Posture Amid Continuing Industry Challenges
2025-12-15
PRWeb
Highmark Inc. and Blue KC Announce Affiliation Agreement
2025-12-11
PRWeb
Highmark Members Saving Money through New Lower-Cost Generic, Biosimilar Drugs
2025-12-08
Company data provided by crunchbase