Healthcare Utilization Specialist (Day Shift)

CoxHealth; Springfield (MO); On-site; USD 42,000 - 54,000; Full time

Benefits offered by this job

Medical benefits

Vision/Dental coverage

Retirement with employer match

Job summary

CoxHealth Plans is seeking a Medical Resource Specialist to support the utilization process and departmental procedures. You will act as a liaison among CHP, providers, and members to ensure accurate, timely processing of requests and adherence to plan guidelines.

The role requires excellent verbal and written communication, independence, and the ability to manage multiple tasks with deadlines in a healthcare setting.

Qualifications

• High School Diploma or equivalent required.
• 3-5 years related experience preferred.
• Excellent verbal and written communication skills.

Responsibilities

• Perform administrative duties associated with utilization processes and department procedures.
• Serve as liaison between Cox HealthPlans, providers, and members to ensure timely processing of requests.
• Promote effective utilization of product lines in accordance with plan provisions and guidelines.

Skills

Communication skills

Independent work

Multitasking

Microsoft Office

Typing skills

Medical terminology

Phone skills

Organizational skills

Education

High School Diploma or Equivalent

Tools

Word

Excel

PowerPoint

Job description

CoxHealth Plans is seeking a Medical Resource Specialist to support the utilization process and departmental procedures. You will act as a liaison among CHP, providers, and members to ensure accurate, timely processing of requests and adherence to plan guidelines.

The role requires excellent verbal and written communication, independence, and the ability to manage multiple tasks with deadlines in a healthcare setting.