Healthcare Operations Coordinator

  • location: Phoenix, AZ
  • type: Contract
  • salary: $18.50 per hour
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job description

Healthcare Operations Coordinator

job summary:
Job Description:

  • Processes phone and fax authorization requests for medical services from physicians and hospital providers in an efficient, accurate and customer-focused manner.
  • Serves as a resource advisor for customer issues such as pending referrals,corrections to initial authorizations, escalated calls from providers and assists with ongoing education of providers regarding protocol.
Key Duties and Responsibilities

  • Effectively handles authorization requests via phone or fax from providers, balancing excellent customer service with efficiency.
  • Follows appropriate procedures for checking member eligibility, authorization history and provider network participation status based on the information provided by the provider and gathered from computer systems.
  • Determines the appropriate handling of each inpatient or outpatient request, utilizes online tools to determine authorization requirements based on the type of service requested, the location of the service and the provider specifics.
  • Accurately enters authorization requests into WellCare's system, based on the authorization rules and urgency of the request, either approves the authorization request or escalates to a nurse for review.
  • Communicates authorization specifics to providers either verbally on phone calls or written through fax.
  • Evaluates and prioritizes incoming providers requests via phone/fax and/or from other Coordinators.
  • Coordinates provider service authorizations of escalated nature for immediate resolution.
  • Assists and provides support to coworkers regarding process flow. job and product knowledge in accordance with ongoing training initiatives.
  • Completes review of routine reports for Supervisor/Manager (as defined & scheduled by Supervisor/Manager).
Education Required:

  • High School or GED Required
Work Experience:

  • 6 months of experience in entry level Intake Coordinator position (pending previous outside experience and current performance) Required
  • 1+ year of experience in entry level Intake Coordinator position (pending previous outside experience and current performance)
  • Other call center experience Preferred
 
location: Phoenix, Arizona
job type: Contract
work hours: 8 to 5
education: High School
experience: 1 Years
 
responsibilities:
Job Description:

  • Processes phone and fax authorization requests for medical services from physicians and hospital providers in an efficient, accurate and customer-focused manner.
  • Serves as a resource advisor for customer issues such as pending referrals,corrections to initial authorizations, escalated calls from providers and assists with ongoing education of providers regarding protocol.
Key Duties and Responsibilities

  • Effectively handles authorization requests via phone or fax from providers, balancing excellent customer service with efficiency.
  • Follows appropriate procedures for checking member eligibility, authorization history and provider network participation status based on the information provided by the provider and gathered from computer systems.
  • Determines the appropriate handling of each inpatient or outpatient request, utilizes online tools to determine authorization requirements based on the type of service requested, the location of the service and the provider specifics.
  • Accurately enters authorization requests into WellCare's system, based on the authorization rules and urgency of the request, either approves the authorization request or escalates to a nurse for review.
  • Communicates authorization specifics to providers either verbally on phone calls or written through fax.
  • Evaluates and prioritizes incoming providers requests via phone/fax and/or from other Coordinators.
  • Coordinates provider service authorizations of escalated nature for immediate resolution.
  • Assists and provides support to coworkers regarding process flow. job and product knowledge in accordance with ongoing training initiatives.
  • Completes review of routine reports for Supervisor/Manager (as defined & scheduled by Supervisor/Manager).
Education Required:

  • High School or GED Required
Work Experience:

  • 6 months of experience in entry level Intake Coordinator position (pending previous outside experience and current performance) Required
  • 1+ year of experience in entry level Intake Coordinator position (pending previous outside experience and current performance)
  • Other call center experience Preferred
 
qualifications:
Job Description:

  • Processes phone and fax authorization requests for medical services from physicians and hospital providers in an efficient, accurate and customer-focused manner.
  • Serves as a resource advisor for customer issues such as pending referrals,corrections to initial authorizations, escalated calls from providers and assists with ongoing education of providers regarding protocol.
Key Duties and Responsibilities

  • Effectively handles authorization requests via phone or fax from providers, balancing excellent customer service with efficiency.
  • Follows appropriate procedures for checking member eligibility, authorization history and provider network participation status based on the information provided by the provider and gathered from computer systems.
  • Determines the appropriate handling of each inpatient or outpatient request, utilizes online tools to determine authorization requirements based on the type of service requested, the location of the service and the provider specifics.
  • Accurately enters authorization requests into WellCare's system, based on the authorization rules and urgency of the request, either approves the authorization request or escalates to a nurse for review.
  • Communicates authorization specifics to providers either verbally on phone calls or written through fax.
  • Evaluates and prioritizes incoming providers requests via phone/fax and/or from other Coordinators.
  • Coordinates provider service authorizations of escalated nature for immediate resolution.
  • Assists and provides support to coworkers regarding process flow. job and product knowledge in accordance with ongoing training initiatives.
  • Completes review of routine reports for Supervisor/Manager (as defined & scheduled by Supervisor/Manager).
Education Required:

  • High School or GED Required
Work Experience:

  • 6 months of experience in entry level Intake Coordinator position (pending previous outside experience and current performance) Required
  • 1+ year of experience in entry level Intake Coordinator position (pending previous outside experience and current performance)
  • Other call center experience Preferred
 
skills: Excel
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.

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