Utilization Review Specialist
Education:
High school graduate or equivalent
Experience:
Prior experience in medical office, social service or case management
experience a plus.
Skills:
Superior customer service and phone skills; strong verbal communication, writing, problem solving, time management, and organizational skills
Must possess professional writing skills and ability to correspond with professionals both verbally and in writing
Ability to accurately type 25 words per minute
Absolutely must have strong spreadsheet and database skills to include intermediate plus proficiency with Microsoft Excel, Word and Outlook
Must be detail orientated and have ability to be creative in developing work functions either independently or as a team member.
Environmental and Working Conditions:
Entire work time is conducted in an office setting
Physical and Mental Requirements:
Must be able to understand and follow complex instructions
Job Description: LogistiCare is the nation's leading managed healthcare organization specializing in the management of healthcare transportation benefits. LogistiCare's client base consists of state and local government agencies (Medicaid agencies, transit authorities, school boards), managed care organizations and hospitals. LogistiCare is not a provider of transportation vehicles (we do not physically own vehicles). Instead, LogistiCare manages a network of transportation providers and provides the administrative infrastructure to authorize services and provide billing and claims payment functionality allowing LogistiCare to offer a complete outsourcing solution to our clients.
We seek a Utilization Review Specialist to join our growing company.
Essential Duties and
Responsibilities:
Determines member Medicaid eligibility
Verifies the appropriateness of service levels
Manages the denial and appeal process
Monitors Medicaid verifications.
Confirms utilization of the closest medical provider of services
Assists with standing order recertification
Audits whether provider billed for previously cancelled trips and/or was paid for trips that did not occur
Performs other duties as assigned
Note: This description is not intended to be all-inclusive. Employee may be requested to perform other duties from time to time.
LogistiCare is an Equal Opportunity Employer.
Apply Now Email A Friend
Apply with LinkedIn
Apply Now
To apply for this career opportunity, please click on the Apply Now link. You may also click on the Email a Friend link to forward this
. Apply now!Estimated Salary: $20 to $28 per hour based on qualifications.
High school graduate or equivalent
Experience:
Prior experience in medical office, social service or case management
experience a plus.
Skills:
Superior customer service and phone skills; strong verbal communication, writing, problem solving, time management, and organizational skills
Must possess professional writing skills and ability to correspond with professionals both verbally and in writing
Ability to accurately type 25 words per minute
Absolutely must have strong spreadsheet and database skills to include intermediate plus proficiency with Microsoft Excel, Word and Outlook
Must be detail orientated and have ability to be creative in developing work functions either independently or as a team member.
Environmental and Working Conditions:
Entire work time is conducted in an office setting
Physical and Mental Requirements:
Must be able to understand and follow complex instructions
Job Description: LogistiCare is the nation's leading managed healthcare organization specializing in the management of healthcare transportation benefits. LogistiCare's client base consists of state and local government agencies (Medicaid agencies, transit authorities, school boards), managed care organizations and hospitals. LogistiCare is not a provider of transportation vehicles (we do not physically own vehicles). Instead, LogistiCare manages a network of transportation providers and provides the administrative infrastructure to authorize services and provide billing and claims payment functionality allowing LogistiCare to offer a complete outsourcing solution to our clients.
We seek a Utilization Review Specialist to join our growing company.
Essential Duties and
Responsibilities:
Determines member Medicaid eligibility
Verifies the appropriateness of service levels
Manages the denial and appeal process
Monitors Medicaid verifications.
Confirms utilization of the closest medical provider of services
Assists with standing order recertification
Audits whether provider billed for previously cancelled trips and/or was paid for trips that did not occur
Performs other duties as assigned
Note: This description is not intended to be all-inclusive. Employee may be requested to perform other duties from time to time.
LogistiCare is an Equal Opportunity Employer.
Apply Now Email A Friend
Apply with LinkedIn
Apply Now
To apply for this career opportunity, please click on the Apply Now link. You may also click on the Email a Friend link to forward this
. Apply now!Estimated Salary: $20 to $28 per hour based on qualifications.
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