Position Information:

• Work Arrangement: Full Office

• Work Schedule: Monday to Friday (8:00 a.m. to 5:00 p.m.)

Duties & Responsibilities:

• 85% - Medical Authorization

• Receives referral requests via fax, phone or electronically and enters new service request information into the authorization system.

• Collects additional information from members and providers to complete referral information.

• Authorizes requested services according to authorization guidelines, performing data entry into the authorization system and verifying eligibility.

• Contacts the health networks and Customer Service regarding health network enrollments.

• Assists the Medical Case Managers in gathering medical records, obtains appropriate coding for diagnosis and procedures and follows up on phone calls as directed by the authorization nurse.

• Documents all contacts and case information in the system using the standard charting format.

• Performs data entry into the appropriate databases for monitoring, tracking and trending of events and other relevant databases as needed.

• 10% - Administrative Support

• Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.

• Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.

• 5% - Completes other projects and duties as assigned.

Minimum Qualifications:

• High School diploma or equivalent required.

• 2 years of experience in a health care or managed care setting required.

• An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.

Preferred Qualifications:

• Bilingual in English and in one of defined threshold languages (Arabic, Chinese, Farsi, Korean, Spanish, Vietnamese).

• Prior authorization and utilization management process experience.

About US Tech Solutions:

US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com.

US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.