[Hiring] Review Coordinator @Medica
Role Description
Medica’s Review Coordinator is responsible for coordinating and supporting all intake functions within the Utilization Management Department, in accordance with departmental policies, regulatory requirements, and accreditation standards. Performs other duties as assigned.
• Triage, research and enter acute inpatient hospital admissions and outpatient medical prior authorization requests
• Triage, research and enter member administrative referrals
• Triage, research and complete non-clinical service requests
• Outreach attempts to providers requesting clinical or additional information needed for the requested reviews
• Research and resolution of provider and member questions and issues while maintaining a positive customer relationship
This is a critical role at Medica, as downstream activities depend upon the timely, accurate processing of information to perform their job functions.
Qualifications
• High School Diploma or Equivalent; Associate’s or Bachelor’s degree preferred
• 2+ years of healthcare industry experience within a professional customer service or related experience
Requirements
• Knowledge of prior authorization or hospital admission processes preferred, however not required
• Advanced data entry skills
• Strong verbal and written communication
• Strong organizational and time management skills
• Ability to manage multiple tasks and priorities
• Analytical and critical thinking skills
• Ability to work with limited supervision
• Attention to detail and accuracy are critical
• Excellent computer skills
Benefits
• Competitive medical, dental, and vision insurance
• PTO and Holidays
• Paid volunteer time off
• 401K contributions
• Caregiver services
• Generous total rewards package
Medica’s Review Coordinator is responsible for coordinating and supporting all intake functions within the Utilization Management Department, in accordance with departmental policies, regulatory requirements, and accreditation standards. Performs other duties as assigned.
• Triage, research and enter acute inpatient hospital admissions and outpatient medical prior authorization requests
• Triage, research and enter member administrative referrals
• Triage, research and complete non-clinical service requests
• Outreach attempts to providers requesting clinical or additional information needed for the requested reviews
• Research and resolution of provider and member questions and issues while maintaining a positive customer relationship
This is a critical role at Medica, as downstream activities depend upon the timely, accurate processing of information to perform their job functions.
Qualifications
• High School Diploma or Equivalent; Associate’s or Bachelor’s degree preferred
• 2+ years of healthcare industry experience within a professional customer service or related experience
Requirements
• Knowledge of prior authorization or hospital admission processes preferred, however not required
• Advanced data entry skills
• Strong verbal and written communication
• Strong organizational and time management skills
• Ability to manage multiple tasks and priorities
• Analytical and critical thinking skills
• Ability to work with limited supervision
• Attention to detail and accuracy are critical
• Excellent computer skills
Benefits
• Competitive medical, dental, and vision insurance
• PTO and Holidays
• Paid volunteer time off
• 401K contributions
• Caregiver services
• Generous total rewards package