UM / Data Entry Tech

Principal Accountability: - 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. - Provides relevant information to members and assists them in resolving Plan related problems when Member Services personnel are not available. - Acts as a resource to staff for questions related to the prior authorization process. - Refers unresolved prior authorization process questions to the Lead Intake Specialist. - Assists the Lead Intake Specialist in identifying, planning and implementing staff training programs. - 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. - Supports Utilization Management nurses with data entry. - Performs other duties as assigned. - Adheres to Select Health and KMHP policies and procedures. - Supports and carries out the Select Health and Mercy Mission & Values. Key Competencies/Success Factors: - Excellent interpersonal and verbal communication skills. - Attention to detail and confidentiality. - Patience and a balanced demeanor. - Professional image. - Ability to write clear and concise reports. - Willingness to work any shift. - Availability for in-service training. Requirements/Certifications: REQUIREMENTS: - High School Diploma / GED - Proficient PC Skills in a Windows based environment including word processing, spread sheets and working in database programs. - Proven ability to keep accurate and timely records and documentation according to established processes - Experience as a medical assistant or role with similar responsibilities - Experience handling multiple calls or triaging calls - Medical Terminology, ICD, CPT, and coding experience All your information will be kept confidential according to EEO guidelines.