• Initiate authorization requests for services in keeping with the prior authorization list.
• Research claims inquiry specific to the department and responsibility.
• Perform tasks necessary to promote member compliance such as verifying appointments, obtaining lab results.
• Screen for eligibility and benefits.
• Thorough knowledge of customer service, utilization review or claims processing practices in a managed care environment
• Identify members without a PCP and refer to Member Services.
• 6 months contract (with a potential for extension)
• M-F 8-5 (1 hour lunch)