• Program Coordinator 1

    TEKsystemsDallas, TX 75219

    Job #2710941899

  • Hiring For Medical Program Coordinator!

    HYBRID/REMOTE TEXAS!

    Note: Candidates from Texas can only apply!

    Candidates who are having 2+yrs of experience in Medical field can only apply!

    Description

    Position Purpose

    Supports the prior authorization request to ensure all authorization requests are addressed properly and in the contractual timeline. Aids utilization management team to document authorization requests and obtain accurate and timely documentation for services related to the members healthcare eligibility and access.

    Walk me through the day-to-day responsibilities of this the role and a description of the project (Outside of Workday JD):

    • Receive incoming medical authorization requests from hospitals via E-fax, phone queue, or web

    • Date enter authorization request and transmit back to facility via E-fax or phone

    Describe the performance expectations/metrics for this individual and their team:

    • Referral Specialist are required to enter five minimum of five structured notes per hour

    Tell me about what their first day looks like

    Supports authorization requests for services in accordance with the insurance prior authorization list

    Responsibilities: Supports and performs data entry to maintain and update authorization requests into utilization management system

    Assists utilization management team with ongoing tracking and appropriate documentation on authorizations and referrals in accordance with policies and guidelines.

    Contributes to the authorization review process by documenting necessary medical information such as history, diagnosis, and prognosis based on the referral to the clinical reviewer for determination.

    Remains up-to-date on healthcare, authorization processes, policies and procedures

    Performs other duties as assigned.

    Complies with all policies and standards

    Education/Experience:

    Requires a High School diploma or GED

    Entry-level position typically requiring little or no previous experience.

    Skills

    Prior authorization, 40+ wpm, provider relations, medical terminology, medical record

    Top Skills Details

    Prior authorization,40+ wpm,provider relations, medical terminology

    Additional Skills & Qualifications:

    What previous job titles or background work well in this role?

    • Referral Specialist

    • Medical Biller or Medical Coder

    • Customer Service Representative

    Experience Level

    Entry Level

    About TEKsystems:

    We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

    The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

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