Remote-Eligible Utilization Management Specialist I

Capital District Physicians Health Plan Inc; Buffalo (NY); Sur place; USD 28 000 - 37 000; Plein temps

Avantages offerts par ce poste

Remote work option

Résumé du poste

Capital District Physicians Health Plan Inc in Buffalo, NY seeks an UM Administrative Support Specialist to handle customer calls, information on services, and authorization requests for inpatient, outpatient, behavioral health, and DME.

You will work in a call-center style environment, maintain member privacy, collaborate across departments, and progress through multi-level roles by demonstrating reliability, problem solving, and teamwork.

Qualifications

• High School Diploma or GED required.
• Experience using a desktop computer in a professional environment; Microsoft Office preferred.
• Call center experience preferred.
• Strong analytical and problem-solving skills.
• Strong written and verbal communication; ability to work in a team.
• Demonstrated organizational skills to manage multiple projects and priorities.
• Self-motivated and able to work independently and with teams.

Responsabilités

• Handle inbound and outbound calls with members and providers, delivering customer-centered service.
• Assist with authorizations via phone, CareAdvance Provider Tool, and fax for various procedures.
• Perform triage for UM Services and serve as primary contact for providers regarding authorization requests.
• Ensure compliance with regulatory requirements and privacy policies.

Connaissances

Microsoft Office

Call center experience

Communication

Organizational skills

Teamwork

Formation

High School Diploma or GED

Description du poste

Capital District Physicians Health Plan Inc in Buffalo, NY seeks an UM Administrative Support Specialist to handle customer calls, information on services, and authorization requests for inpatient, outpatient, behavioral health, and DME.

You will work in a call-center style environment, maintain member privacy, collaborate across departments, and progress through multi-level roles by demonstrating reliability, problem solving, and teamwork.