Pay Range: $23/hr -$26/hr

Benefits:
The Company offers the following benefits for this position, subject to applicable eligibility requirements: medical insurance, dental insurance, vision insurance, 401(k) retirement plan, life insurance, long-term disability insurance, short-term disability insurance, paid parking/public transportation, (paid time , paid sick and safe time , hours of paid vacation time, weeks of paid parental leave, paid holidays annually - AS Applicable)

About the Role:

• This position is 100% remote but requires the candidate to live in CA and adhere to a Monday to Friday 8:30-5:30 PST schedule.
• The role involves working within the Care Access and Monitoring (CAM) team to provide clerical and data entry support for client Members requiring hospitalization and/or utilization review for other healthcare services.

Responsibilities:

• Verify member eligibility and benefits
• Determine provider contracting status and appropriateness
• Assign billing codes and verify inpatient hospital census
• Respond to authorization requests via phone, fax, and mail
• Collaborate with other departments to enhance continuity of care
• Provide excellent customer service for internal and external customers
• Maintain confidentiality and comply with HIPAA regulations
• Participate in team meetings and follow company policies and guidelines

Education Qualification:

• High School Diploma/GED

Required Skills:

• 2-4 years of experience in a Utilization Review Department in a Managed Care Environment 
• Previous Hospital or Healthcare clerical, audit, or billing experience
• Experience with Medical Terminology
• Strong communication, problem-solving, and interpersonal skills
• Ability to work independently and as part of a team
• Proficient in MS Office software
• Accurate data entry at a minimum of 40 WPM