UM / Data Entry Tech
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Overview
Job Description
UM / Data Entry TechPrincipal Accountability:Screens information received and refers members to the appropriate provider and/or contacts the provider directly for members.Facilitates the authorization process for requests that do not require clinical criteria application or judgment.Provides relevant information to members and assists them in resolving Plan related problems when Member Services personnel are not available.Acts as a resource to staff for questions related to the prior authorization process.Refers unresolved prior authorization process questions to the Lead Intake Specialist.Assists the Lead Intake Specialist in identifying, planning and implementing staff training programs.Identifies and reports member and provider educational opportunities to the Lead Intake Specialist.Accurately answers questions regarding Plan benefits and Utilization Management requirements for members and providers.Makes appropriate inquiries to determine potential coordination of benefits and advises appropriate provider and claims staff of same.Supports Utilization Management nurses with data entry.Performs other duties as assigned.Adheres to Select Health and KMHP policies and procedures.Supports and carries out the Select Health and Mercy Mission & Values.Key Competencies/Success Factors:Excellent interpersonal and verbal communication skills.Attention to detail and confidentiality.Patience and a balanced demeanor.Professional image.Ability to write clear and concise reports.Willingness to work any shift.Availability for in-service training.Requirements/Certifications:REQUIREMENTS:High School Diploma / GEDProficient PC Skills in a Windows based environment including word processing, spread sheets and working in database programs.Proven ability to keep accurate and timely records and documentation according to established processes
Experience as a medical assistant or role with similar responsibilities
Experience handling multiple calls or triaging calls
Medical Terminology, ICD, CPT, and coding experience
Additional Information:All your information will be kept confidential according to EEO guidelines.
Automate your job search with Sonara.
Submit 10x as many applications with less effort than one manual application.
