Utilization Management Technician

JOB SUMMARY

This position is responsible for data entry of referral requests and modification requests received from requesting providers via fax review. 

ESSENTIAL DUTIES AND RESPONSIBILITIES

Include the following. Others may be assigned.

• Responsible for the prompt and accurate entry of all referral information into the company’s data entry system within one day of receipt for non-urgent requests and within 4 hours for urgent requests.
• Responsible for correct identification and labeling of the referral request priority status.
• Responsible for assuring that services are kept in-network and with preferred/contracted providers by proper selection of the specialist within Ezcap.
• Must be able to process a minimum of 120 referrals in a 7.5-hour day.
• Responsible for accurate data entry of the STAT referrals into EZCap within 1 hour of receipt.
• Responsible for working the correspondence queue and maintaining all modification requests within 2 days of receipt.
• Responsible for attending meetings and trainings as assigned. Maintains and keeps in total confidence, all files, documents, and records that pertain to the operation of business of Cap Management Systems
• All other job-related duties as it relates to the job function or as delegated by the management team.

KNOWLEDGE, SKILLS, ABILITIES

• Two years medical assistant experience in physician office. Knowledgeable of medical terminology.  One year managed care experience.  Experience with Excel, Word, and general computers.

Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment.  This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings.

EDUCATION / EXPERIENCE

• High School Diploma, GED or equivalent work experience. 

REQUIRED CERTIFICATIONS/LICENSURE

Include minimum certification required to perform the job.

• Prefer two years of college in general education.

PHYSICAL DEMANDS 

• Light physical effort (lift up to 10 lbs.).  Mostly sedentary work. Regularly needs to be able to bend, stoop and reach to file. 

WORK ENVIRONMENT

• Office Work Environment
• Remote Location

OTHER

• No Travel required for this job.

As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities, and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions?  Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!

Compensation and Benefit Information

Compensation

• Pay: $14.50 - $21.80 per hour. Compensation depends on location, qualifications, and experience. 
• Position may be eligible for a signing bonus for qualified new hires, subject to employment status.
• Conifer observed holidays receive time and a half.

Benefits

Conifer offers the following benefits, subject to employment status:

• Medical, dental, vision, disability, and life insurance
• Paid time off (vacation & sick leave) – min of 12 days per year, accrue at a rate of approximately 1.84 hours per 40 hours worked.
• 401k with up to 6% employer match
• 10 paid holidays per year
• Health savings accounts, healthcare & dependent flexible spending accounts
• Employee Assistance program, Employee discount program
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance.
• For Colorado employees, Conifer offers paid leave in accordance with Colorado’s Healthy Families and Workplaces Act.