Utilization Review Tech. (El Paso Health

Position: Utilization Review Tech. (El Paso Health)
Summary

Job Summary As the front line of the pre-certification process, ensures a high volume of pre-certification authorization requests and calls are processed accurately and timely. Provides great customer service when addressing Members, Providers, in relation to the health plan. Assists with a variety of Health Plan activities. Schedule flexibility is required, as schedules can be early shifts (7:00 a.m.

- 4:00 p.m.) and/or late shifts (8:30 a.m.

- 5:30 p.m.), and work assignments may fluctuate according to workload. Skills
1. Ability to type 45 wpm. 2. Great customer service and interpersonal skills
3. Excellent verbal and written communication and interpersonal skills.
4. Proficient with the use of Microsoft Office applications.
5. Excellent time management skills in order complete daily authorization requests.
6. Possesses problem analysis and problem-solving skills.
7. High attention to detail and accuracy.
8. Ability to work under high stress.
9. Ability to prioritize work projects and complete them in a timely manner. 10. Ability to analyze information, plan effective actions and follow thru reliably to meet expectations. 11. Ability to function independently and as team member. 12. Bilingual (English and Spanish) highly desired. Work Experience Two years progressive clerical experience in a health related field required. Experience in office setting with excellent customer service skills required.

Knowledge of managed care and/or health care industry, familiar with medical terminology and experience with the authorization process of health care benefits is preferred. License/Registration/Certification None Education and Training High school degree or equivalent required.