Managed Care Coordinator

Job Summary

A company is looking for a Managed Care Coordinator I.

Key Responsibilities:

• Review service requests for completeness and collect non-clinical data from physicians and patients
• Prepare and route cases for clinical review, initiating communication with members and providers as needed
• Assist members with finding providers, resolving issues, and coordinating case management activities

Required Qualifications:

• High School Diploma/GED required
• 1-2 years of experience in customer service or a medical support-related position preferred
• Knowledge of medical terminology is required; knowledge of Medicaid CM is preferred
• Familiarity with managed care principles and claims processing preferred
• Ability to use a personal computer and relevant software is preferred