Utilization Management Technician

Utilization Management Technician 3024158

• Hourly pay: $28/hr
• Worksite: One of the most prestigious and well-known universities (Los Angeles, CA 90045 - Onsite)
• W2 Employment, Group Medical, Dental, Vision, Life, Retirement Savings Program
• 40 hours/week, 3 Month Assignment

One of the most prestigious and well-known universities is seeking a Utilization Management Technician. The successful candidate will be Responsible for accurately and timely processing prior authorization requests using clinical guidelines, business applications, and customer interactions to support claims adjudication and ensure high-quality service. The company offers a great work environment!

Utilization Management Technician Responsibilities:

• Process urgent, routine, pre-service, and retro prior authorization requests accurately and on time
• Analyze and enter authorization data using various business applications
• Identify missing information and apply clinical protocols to make processing decisions
• Communicate with internal and external stakeholders to exchange necessary information
• Ensure high-quality service and compliance with claims adjudication guidelines

Utilization Management Technician Qualifications:

• Process urgent, routine, pre-service, and retro prior authorization requests accurately and within required timeframes
• Utilize business applications to analyze data, obtain information, and input prior authorization details for claims adjudication
• Apply clinical protocols and critical thinking to identify missing information and make informed processing decisions
• Communicate effectively with internal teams and external providers to ensure smooth information exchange
• Deliver high-quality service while adhering to the health plan and compliance guidelines

Utilization Management Technician Shift:

• 8:00 AM to 5:00 PM