Remote Utilization Management Technician

Socket.dev; United States; Hybrid; USD 45,000 - 65,000; Full time

Benefits offered by this job

Remote options

Hybrid work schedules

Paid time off including holidays and—

Job summary

AmeriHealth Caritas in the United States seeks a LTSS UM Tech to support utilization management functions, coordinating authorizations and communications with providers.

Under the LTSS Supervisor, you will enter data, track correspondence, notify participants by phone, and help maintain timely reviews. A healthcare background and strong MS Office skills are preferred.

This role offers flexible work solutions including remote or hybrid schedules with competitive pay and benefits.

Qualifications

• High School/GED required.
• Minimum 1 year general office or customer service experience.
• Healthcare setting experience preferred.
• Knowledge of medical terminology beneficial.

Responsibilities

• Coordinate and track correspondence, faxes, and authorizations for UM reviews.
• Interact with providers and LTSS UM staff to obtain necessary records.
• Provide telephonic verbal notifications to participants to maintain UM compliance.
• Perform data entry of authorizations and maintain operational reports.
• Work with providers to correct authorization to claim issues.
• Maintain knowledge of workflow and timeliness requirements across UM areas.

Skills

MS Office

Data entry

Phone communication

Education

High School Diploma or GED

Job description

AmeriHealth Caritas in the United States seeks a LTSS UM Tech to support utilization management functions, coordinating authorizations and communications with providers.

Under the LTSS Supervisor, you will enter data, track correspondence, notify participants by phone, and help maintain timely reviews. A healthcare background and strong MS Office skills are preferred.

This role offers flexible work solutions including remote or hybrid schedules with competitive pay and benefits.