• Referral bonus opportunities

• Generous paid time off (PTO), starting at 20 days of paid time off and 9 company holidays

• Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability

• Employer-matched retirement saving funds

• Personal and financial wellness programs

• Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care

• Generous tuition reimbursement for qualifying degrees

• Opportunities for professional growth and career advancement

• Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities

What You Will Do

• Creates and modifies authorizations and/or orders for new and existing Members in an accurate and timely matter

• Researches, troubleshoots, resolves authorization and/or order processing issues and discrepancies

• Completes activities, including but not limited to, inbound/outbound calls, as assigned, faxes and emails

• Obtains information from internal and external sources. Processes or triages the request via our medical management information system or external sources

• Coordinates with Providers and Members regarding authorization requests and/or activities

• Communicates with Care Management, Member Services, Membership and Eligibility and other internal departments regarding Member services, authorization requests and issues

• Reviews all authorization requests for accuracy and prioritizing based on urgency

• Documents communication, actions taken and barriers in the Medical Management System as it pertains to the Members Care or request for services

• Utilizes internal and external systems to verify eligibility and Provider Information such as name, address, fax number, NPI and TAX ID.

• Conducts follow-up, as necessary, to ensure member satisfaction and successful delivery of service

• Protects the confidentiality of member information and adheres to company policies regarding confidentiality.

• Participates in special projects and performs other duties as assigned.