Care Review Processor Job

CARE REVIEW PROCESSOR needed for a CONTRACT opportunity with Yoh's client located in MIAMI, FL.

TOP SKILLS YOU SHOULD POSSESS:

- Managed Care experience
- Knowledge of Medical Terminology

WHAT YOU'LL BE DOING:

- Provide clerical and data entry support for members that require hospitalization and/or utilization review for other healthcare services
- Check eligibility and verify benefits, obtain and enter data into systems, process requests, and triage members and information to the appropriate Health Care Services staff
- Serve as first level of Utilization Review; review request, create authorization in QNXT, and respond to requester

WHAT YOU NEED TO BRING TO THE TABLE:

- High School Diploma/GED
- One to two (1-2) years of experience in a Utilization Review Department in a Managed Care environment
- Previous Hospital or Healthcare clerical, audit or billing experience
- Experience with Medical Terminology
- Accurate data entry at 40 WPM minimum
- Experience with QNXT or InterQual
- Demonstrated ability to communicate, problem solve, and work effectively with people

WHAT ARE YOU WAITING FOR? APPLY NOW!

RECRUITER: Jennifer Andersen

Yoh, a Day & Zimmermann company, is an Equal Opportunity Employer, M/F/D/V. Contact us if you are an individual with a disability and require accommodation in the application process.

J2W: HC

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