UM / Data Entry Tech

IA · 110 months ago

About the job

Job Description Principal 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...