Full Time, Hr Review Coordinator

Medica’s Review Coordinator II is responsible for coordinating and supporting all intake functions into the Utilization Management and Clinical Appeals Department in accordance with all department policies, regulatory and accreditation requirements.

Key Elements:

• Research and resolution of provider and member questions and issues while maintaining a positive customer relationship
• Triage, research and complete non-clinical service requests
• Outreach attempts to providers requesting clinical or additional information needed for the requested reviews
• Triage, research and enter member administrative referrals
• Triage, research and enter acute inpatient hospital admissions

This is a critical role at Medica, as downstream activities, depend upon the timely, accurate processing of information to perform their job functions.

Qualifications:

• 2+ years of healthcare industry experience within a professional customer service or administrative type function
• High School Diploma or Equivalent; Associate’s or Bachelor’s degree preferred
• Knowledge of prior authorization or hospital admission processes preferred, however not required

Skills and Abilities:

• Strong organizational and time management skills
• Analytical and critical thinking skills
• Ability to manage multiple tasks and priorities
• Strong verbal and written communication
• Advanced data entry skills
• Excellent computer skills
• Attention to detail and accuracy are critical
• Ability to work with limited supervision

This position is a Remote role. The employee must be located in any state in which Medica is an employer and will work remotely 100% of the time.