Posting Date: 4/27/2018
Open Until Filled
Salary: $26,535 to $29,348 Annually
Salary is based on education & experience
Job Description: Performs moderately complex utilization management clerical tasks. Checks’ for eligibility for Managed Care Organizations (MCO) plans after receiving authorization for services. Generates Service Request Forms (SRF) as required and monitors receipt of authorizations form MCO’s. Respond to any denials for authorization providing additional data as needed. Maintains database of authorizations for consumers receiving benefits from MCO’s and generates a spreadsheet tracking authorizations sent and authorizations received. Monitors changes in Consumer elections of MCO’s and ensures Service Request Forms are submitted to new MCO’s. Notifies both billing and UM of all MCO changes, assists billing to resolve SRF issues if denials of payment are due to authorization issues. This position will work closely with the Billing department to expedite authorization of services and payment of claims by MCO’s. Work is reviewed periodically while in progress and upon completion for accuracy and conformance to procedures.
Education: Requires High School Diploma or GED.
Experience: Requires a working knowledge of basic computer applications including use of applications such as database and word processing functions. Successful candidate will be self-motivated, have to ability to multi-task and be able to work and coordinate with multiple departments such as Utilization Management, Billing and Information Systems. Attention to detail is essential.
Hours of Work: 8am—5pm; Monday through Friday.
Licenses/Certifications: Current Texas driver’s license and be insurable by Agency insurance.
Physical Requirements: Lifting less than 10lbs., manual dexterity, normal vision and hearing, stooping and kneeling, Must have ability to communicate effectively both orally and in writing; the ability to pass the Preventative Management of Aggressive Behavior (PMAB) Training as well as all other physical requirements for this position.
Facility: Administration, Bryan, TX.