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positions.)
Career Field
Medical/Case Management
Insurance
Discipline
All
Relocation
Assistance
Not Available
Job
Duration
Full Time
Salary
Offered
Open
Handles incoming provider calls requesting referrals, hospital admission or outpatient services authorizations. Creates cases in UM system by gathering demographic, and case specific information. Through discussion with providers, codes case with ICD9, HCPC or CPT codes. Determines network and contract eligibility. Authorizes sessions based on system protocols. Refers cases requiring clinical review to appropriate nurse teams. Triages non-authorization calls. Handles requests from physicians for peer review. May act as liaison between Medical Management and internal departments.
