In this vital role, you will serve as a key resource in the utilization management process, ensuring authorization requests are handled accurately and within contractual timelines. Working standard business hours Monday through Friday (8:00 AM – 5:00 PM with an hour lunch), you will review task queues, verify member insurance coverage, and research essential medical details including diagnoses and treatment histories. You will match approved requests with in-network providers, enter clean data into utilization management systems, and route complex cases to clinical reviewers. You will thrive within a family-style team culture featuring dedicated group chats for questions, open communication, and leadership invested in your career development. If you bring a strong background in customer service, sharp Microsoft Excel skills, and a commitment to quality, this 3-month contract-to-hire opportunity provides the perfect launchpad for your long-term success.
salary: $22.99 - $23 per hour
shift: First
work hours: 8 AM - 5 PM
education: High School
Responsibilities
Position Summary:
Review authorization requests, verify member insurance eligibility, research medical documentation, match approvals with providers, and enter data into utilization management systems.
Key Responsibilities:
- Review and process prior authorization requests within designated timeframes.
- Verify member insurance benefits and healthcare eligibility using internal systems.
- Research medical records, diagnoses, and referral documentation for clinical review.
- Coordinate approved authorizations to pair members with network providers.
- Maintain a 95% quality audit score and comply with regulatory requirements.
- High School Diploma or GED equivalent required.
- 1–2 years of experience in healthcare customer service, authorizations, or compliance.
- Working knowledge of medical terminology and insurance guidelines.
- strong proficiency in Microsoft Office, particularly Microsoft Excel and Teams.
- Private, dedicated home office space located within Florida.
Skills
Qualifications
Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.
Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.
At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact HRsupport@randstadusa.com.
Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).
This posting is open for thirty (30) days.
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
