Employer Industry: Health Insurance

Why consider this job opportunity:
- Salary up to $66,045
- Comprehensive health benefits including Medical, Dental, and Vision
- Generous Paid Time Off (PTO) and Incentive Plans
- Opportunities for career advancement and professional growth
- Supportive work environment with wellness programs and paid volunteer time off
- Tuition reimbursement for continuing education

What to Expect (Job Responsibilities):
- Input and update demographic customer and clinical data for utilization management programs
- Assist in training new Analysts and Review Specialists, and monitor their performance
- Act as a resource for Review Specialists, providing guidance and coaching
- Monitor phone queues and adjust personnel to meet metrics and timeliness standards
- Serve as a liaison for Medicaid Fair Hearings, ensuring compliance during the appeals process

What is Required (Qualifications):
- High School Diploma or GED required
- Minimum of two (2) years of utilization management or appeals experience
- Knowledge of health care delivery systems and community resources
- Familiarity with CPT-4 and ICD-9 coding
- Strong oral and written communication skills

How to Stand Out (Preferred Qualifications):
- Experience with current Medical Management systems
- Ability to type 25 words per minute

#HealthInsurance #CareerOpportunity #Healthcare #EmployeeBenefits #UtilizationManagement

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