Utilization Review Specialist & Case Management Coordinator

NOR Healthcare Systems Corp.; Bellflower (CA); Presencial; USD 32.000 - 41.000; Jornada completa

Descripción de la vacante

NOR Healthcare Systems Corp. in Bellflower, CA is seeking an Utilization Review Specialist to manage back-office case management functions.

You will interface with payors and providers for authorizations and medical records, ensure timely reviews, and support the team with scheduling and clerical tasks. The role requires knowledge of utilization management, strong customer service skills, and proficiency with computer systems.

Formación

• Knowledge of utilization management.
• 2 years work experience.
• Customer service skills appropriate to the job.
• Computer literacy and proficiency.
• Excellent written and verbal communication skills.
• Ability to establish and maintain effective working relationships within the organization.
• Ability to multitask and maintain a work pace appropriate to workload.

Responsabilidades

• Interfaces with payors and providers requesting authorizations and records.
• Performs basic reception tasks and maintains filing systems.
• Clears providers prior to patient access and ensures privacy compliance.
• Maintains audits for timely Utilization Reviews and reports to Director.
• Collects data and prepares materials for PI/Quality tasks.

Conocimientos

Utilization management

2 years experience

Customer service skills

Computer literacy

Written and verbal communication

Relationship building

Multitasking

PowerPoint

Herramientas

Microsoft Office

EMR systems

Descripción del empleo

NOR Healthcare Systems Corp. in Bellflower, CA is seeking an Utilization Review Specialist to manage back-office case management functions.

You will interface with payors and providers for authorizations and medical records, ensure timely reviews, and support the team with scheduling and clerical tasks. The role requires knowledge of utilization management, strong customer service skills, and proficiency with computer systems.