Diabetes Utilization Management CSR

Job Summary

To support timely access to diabetes therapies, the fully remote Diabetes Utilization Management CSR will manage incoming and outgoing calls, process requests for diabetes-related therapies, and ensure compliance with HIPAA while collaborating with healthcare professionals and patients.

Key responsibilities:

• Review and process requests for diabetes-related therapies, ensuring accurate documentation and timely order processing
• Submit and track prior authorization requests with insurance providers, resolving any authorization denials
• Collaborate with clinical staff and serve as a liaison between internal teams, providers, and vendors to support continuity of care

Required qualifications:

• High school diploma or GED
• 2+ years of experience in a fast-paced medical customer service role
• Proficiency in using computer systems and maintaining accurate records
• Ability to manage multiple tasks and prioritize workload effectively
• Experience with healthcare software and understanding of medical necessity criteria preferred