Managed Care Coordinator

Job Summary

Supporting Clinical Operations, the full-time Managed Care Coordinator will manage service requests, coordinate non-clinical data collection, and liaise with members and providers in a remote environment.

Key responsibilities

• Review service requests for completeness and gather necessary data from physicians and patients
• Document and route cases for clinical review while coordinating benefits with members and providers
• Conduct initial screenings for pre-certification requests based on established scripts and workflows

Required qualifications

• High School Diploma required; some college preferred
• 1-2 years of experience in customer service or a medical support role preferred
• Knowledge of medical terminology is required
• Familiarity with managed care principles and claims processing preferred
• Ability to use personal computers and relevant software applications