Managed Care Coordinator

Job Summary

A company is looking for a Managed Care Coordinator I.

Key Responsibilities:

• Review service requests for completeness and collect necessary data from members and providers
• Prepare and document cases for clinical review and coordinate with members and providers
• Assist members with finding providers and resolving inquiries related to services and appeals

Required Qualifications:

• High School Diploma/GED required
• 1-2 years of experience in customer service or a medical support role preferred
• Knowledge of medical terminology is required; knowledge of Medicaid CM is preferred
• Understanding of managed care principles and claims processing preferred
• Ability to use a personal computer and relevant software is preferred