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Results for "Utilization Management"

2 gigs found around $100 across all platforms

AllDesign & CreativeDesign & Creative83Development & TechDevelopment & Tech509Writing & ContentWriting & Content22Marketing & SEOMarketing & SEO125Business & ConsultingBusiness & Consulting254Video & AnimationVideo & Animation7Music & AudioMusic & Audio
HimalayasView price

UM Denials Coordinator

About The Role BHPS provides Utilization Review services to its clients. The UM Denials Coordinator supports the Utilization Management function by reviewing denied and partially denied authorizations and preparing denial correspondence within the Utilization Management system. This role is responsible for drafting, editing, and formatting denial and partial denial letters to ensure clarity, accuracy, completeness, and appropriate readability, while maintaining compliance with regulatory requirements and client-specific service level agreements. The position works closely with physicians and nursing staff and may require follow-up phone calls or email communication to clarify determinations, obtain additional information, or resolve discrepancies prior to letter release. The UM Denials Coordinator reports to the Clinical Services team and performs a range of moderately complex administrative and operational tasks in support of UM activities. This is a fast-paced, productivity-driven r

Utilization ManagementNursingHealthcare Administration
United States
about 9 hours ago
HimalayasView price

Support Coordinator

The Support Coordinator is responsible for assisting the care/case managers with non-clinical activities such as creating cases and events; managing authorizations; providing telephonic outreach to members, providers and community-based organizations; handling member mailings; faxing clinical requests and Individual Health Care Plans on behalf of the care/case managers. The Support Coordinator is assigned to a specific clinical team (such as Care Management, Utilization Management, Behavioral Health, etc.) and may have additional departmental responsibilities. Duties and Responsibilities: Provides excellent quality customer service to our members and/or providers relating to authorization updates, questions/issues such as coordinating care, DME outreach, scheduling appointments, and screen assessments to identify risk factors which need closer intervention Handles calls to and from providers regarding authorizations, referrals, visits, tests, and faxed care plans Manage requests from m

Customer ServiceSupport CoordinatorCare Management
United States
9 days ago