Overview

DescriptionAssist in activities related to the medical and psychosocial aspects of utilization and coordinated care.• Initiate authorization requests for output or input services in keeping with the prior authorization list. Research claims inquiry specific to the department and responsibility.• Perform tasks necessary to promote member compliance such as verifying appointments, obtaining lab results. Assess and monitor inpatient census.• Screen for eligibility and benefits. Identify members without a PCP and refer to Member Services. Screen members by priority for case management (CM) assessment. Perform transition of care duties to include but not limited to, contact the member’s attending physician, member or medical power of attorney, other medical providers (home health agencies, equipment vendors) for information pertaining to special needs.• Coordinate services with community based organizations. Attend marketing and outreach meetings as directed to represent the plan. Produces and mails routine CM letters and program educational material.• Data enter assessments and authorizations into the system.RequirementsMedical Insurance, Medical Insurance Verification, Authorization Requests, Medical Terminology, Medical Terminology KnowledgeOfficeTeam, a Robert Half Company, matches professionals in the administrative field with remote or on-site jobs on a temporary and temporary-to-full-time basis. Whether you’re a seasoned administrative pro or starting your career, we have options for you.Our experienced staffing professionals can promote you to employers and advocate on your behalf. We provide access to top jobs, competitive compensation and benefits, and free online training. For more opportunities, get the Robert Half app and receive instant notifications when our AI matches your skills and experience with jobs.When you work with us, you’re working with the best. has been recognized as one of FORTUNE’s “Most Admired Companies” every year since 1998 and was named to Forbes’ inaugural list of America’s Best Temporary Staffing Firms.Questions? Call your local office at 1.. All applicants applying for U.S. job openings must be authorized to work in the United States. Benefits are available to temporary professionals. Visit for more information.© 2020 OfficeTeam. An Equal Opportunity Employer. M/F/Disability/Veterans. By clicking “Apply Now,” you’re agreeing to Robert Half’s Terms of Use ().Tracking

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