[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. They are seeking a Healthcare Utilization Management Intake Analyst to 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
- Knowledge of educational assessments and learning strategies
- Must be knowledgeable of and able to use standard, basic grammar, punctuation, and spelling
- Associate or bachelor s degree in health care related field
- Current unrestricted LPN license or certified Medical Assistant designation
- Minimum of one year experience in a health care related field. Preferred setting is hospital, medical doctor s office, or health insurance company
Benefits
- Up to 16 days of paid vacation per year
- 6 days of paid sick leave each year (pro-rated for new hires throughout the year)
- 10 paid holidays
- Paid bereavement leave
- 401(k) Retirement Plan with employer matching
- Medical, dental, and vision insurance
- Basic life insurance
- Accidental death and disability insurance
- Short- and long-term disability benefits
- Additional voluntary short-term disability benefits
- 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
Company Overview
Company H1B Sponsorship