McLaren Health Care Intake Specialist in Flint, Michigan
for the intake of information regarding the authorization of services for
members of all product lines, including communication to the case managers.
Works with the PCP, the member and management to promote the delivery of
quality services at the most appropriate and cost-effective setting. Monitors members’ utilization patterns for
identification of high-risk and under and over use of services. Clarifies
benefits for providers.
Highschool diploma or equivalent.
Completion of a medical-related trainingprogram such as Medical Assistant, EMT or Nursing Assistant.
Two (2) years’ experienceworking in a medical practice office, an urgent care, hospital, skillednursing facility or other health care setting
One (1) yearManaged Care Utilization review experience
Experience andknowledge of the preauthorization process for medical services
Experience andknowledge of Medicare, HMO, PPO, TPA, PHO and Managed Care functions (e.g.administration, medical delivery, claims processing,membership/eligibility)
Primary Location: Michigan-Flint-McLaren Health Plan Bldg
Employee Status Regular
Job Type Standard
Req ID: 20003530