Available Positions

Total Population Health Assistant at Health Insurance Company in Hartford, Connecticut, United States —

  • Healthcare
  • Health Insurance Company
  • Hartford, Connecticut, United States
  • 7/6/20

Job ID: 1030438

Job Description

  • Health insurance organization looking for a Total Population Health Assistant to join their team
  • Responsibilities will include:
    • Enter and approve or pend authorizations for all services and lines of business, upon receipt of inbound utilization management requests
    • Respond to inquiries from providers, members and facility employees
    • Recognize when it is appropriate to triage inquiry to TPH clinician for additional review
    • Perform telephonic triage for TPH prior-authorization ACD line, when assigned
    • Enter and maintain documentation in the TPH platform meeting defined timeframes and performance standards
    • Communicate authorization decisions and important benefit information to providers and members in accordance with applicable federal and state regulations
    • Communicate with members and providers regarding member’s authorization status
    • Establishes and maintains a process for collecting member-specific clinical and demographic data from providers and other entities when requested by TPH clinical staff

Qualifications

1-2+ years of call center or data entry experience in a utilization or care management environment

ICD-10 and CPT coding knowledge preferred

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