REMOTE – Healthcare Administrative Coordinator $23 Per Hour

REMOTE – Healthcare Administrative Coordinator $23 Per Hour

TEKSYSTEMS is seeking Health Care professionals to work at a major healthcare company in the USA.

Job Description:

Responsible for providing non-clinical support to the utilization management team in maintaining and managing the utilization processes for pre-service authorization requests in a timely and accurate manner consistent with policies and procedures as described in the Utilization Management plan.

? Consistently exhibits behavior and communication skills that demonstrate commitment to superior customer service, including quality, care and concern with each and every internal and external customer.

? Performs all functions of the care coordinator.

? Provides non-clinical support to the CDU nurse in the processing of all adverse determinations and notices including provider outreach for denial avoidance, accessibility verification and benefit validation.

? Ensures informational notices for carve outs and benefits are composed in a manner consistent with federal regulations, state regulations, health plan requirements and NCQA standards.

? Converts service description and diagnosis into language that is easily understood based on resources provided and clinical direction.

? Validates the accuracy of all information provided in the carve out and benefit notices including carve out providers and contact information provided relevant to aforementioned notices.

? Contacts members or providers for continuity of care services related to carve out notices.

EXPERIENCE:

Minimum:

° 1 year of experience performing non-clinical functions for prospective review.

Preferred:

° 1 year of experience providing supportive or direct functions for adverse determinations.

° 3 to 5 years of experience in a health care setting.

° 2 years referrals management or related experience.

HOURS:

8:00-5:00pm – Monday – Friday and possible weekend needed

PAY:

$23.00 / hour

This is a CONTRACT position – 6 month contract. About TEKsystems:

We’re partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That’s the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

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