Integrated Resources INC

Integrated Resources INC

UM / Data Entry Tech

Des Moines, IA, United States

Sponsorship not specifiedDetected 3234 days ago
Communication

About the role

  • - Screens information received and refers members to the appropriate provider and/or contacts the provider directly for members.
  • - Facilitates the authorization process for requests that do not require clinical criteria application or judgment.

Responsibilities

  • Refers unresolved prior authorization process questions to the Lead Intake Specialist.
  • Assists the Lead Intake Specialist in identifying, planning and implementing staff training programs.
  • Supports Utilization Management nurses with data entry.
  • Performs other duties as assigned.

Requirements

  • Proven ability to keep accurate and timely records and documentation according to established processes
  • Experience handling multiple calls or triaging calls
  • Ability to write clear and concise reports.

Benefits

  • Identifies and reports member and provider educational opportunities to the Lead Intake Specialist.
  • Accurately answers questions regarding Plan benefits and Utilization Management requirements for members and providers.
  • Makes appropriate inquiries to determine potential coordination of benefits and advises appropriate provider and claims staff of same.
  • Adheres to Select Health and KMHP policies and procedures.
  • Supports and carries out the Select Health and Mercy Mission & Values.

This listing is sourced directly from Integrated Resources INC's careers page and normalized into a canonical job model.