Utilization Management Coordinator
CurrentResponsible for reviewing transportation requests initiated by providers/members and verifying provider and facility information. Review and determine the need for transportation requests to obtain necessary information to determine medical necessity of requests. Ensures documentation is accurate and in compliance with regulatory requirements and standards. Collaborate and communicate with management on issues and processes that impact daily job duties. Remain knowledgeable of other department’s roles as they pertain to Member Services standard work processes, to ensure proper handling of calls.