About this opportunity
AmeriHealth Caritas lists this Long Term Services & Support Utilization Management Technician opportunity in newtown square, Pennsylvania. Review the employer’s description below for duties, qualifications and application requirements.
Job description
For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for reimbursement.
nYour career starts now. We're looking for the next generation of health care leaders.
nAt AmeriHealth Caritas, we're passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we'd like to hear from you.
nHeadquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.
nDiscover more about us at .
nJob Summary
nUnder the direction of the Long-Term Services and Supports (LTSS) Supervisor, the LTSS UM Tech will:
nnnCoordinate, generate and track both incoming and outgoing correspondence, faxes and authorizations related to prospective, concurrent, and post service review functions.
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nnInteracts with providers, service coordinators, and LTSS UM staff to facilitate receipt of information, and/or records for prompt review and response.
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nnProvides Telephonic verbal notification to participants to maintain UM compliance under the CHC Final Agreement.
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nnPerforms data entry of authorizations to ensure authorizations are provided timely and accurately.
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nnPerforms data entry and maintains operational reports.
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nnWorks with Providers to correct authorization to claim issues.
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nnPerforms and remains knowledgeable in all workflow and timeliness requirements for all areas in Utilization Management.
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n nEducation/Experience
nnnHigh School/GED.
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nnHigh School Diploma or GED required.
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nnMinimum 1 year general office and/or customer service experience required.
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nnWork experience in healthcare setting required.
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nnKnowledge of medical terminology required.
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nn1 or 3 years General Office or Customer Service experience.
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n nOther Skills
nnProficiency with Microsoft Office Suite (Word, Excel, PowerPoint, Teams, One Note). Advanced Excel skills is a plus. Consistent word processing speed and accuracy of 50 or more words per minute. Proficiency with telephonic communications and speaking with Participants. Proficient working on computer all day with electronic records.
n nOur Comprehensive Benefits Package
nFlexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.
nAs a company, we support internal diversity through:
nRecruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.
Worksite address
newtown square, PA, 19073, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.