[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 integrated solutions for health plan operations. They are seeking a Healthcare Utilization Management Intake Analyst to support the coordination of medical services, including utilization management intake and medical records 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
• Minimum of one year experience in a health care related field
• 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
• Preferred setting is hospital, medical doctor s office, or health insurance company
• Current unrestricted LPN license or certified Medical Assistant designation preferred

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
• May 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