Utilization Management Representative

Job Summary

A company is looking for a Utilization Management Representative to coordinate prior authorization reviews and ensure compliance with regulations.

Key Responsibilities

• Coordinate cases for prior authorization reviews and verify insurance for DME supplies
• Communicate with members, providers, and internal departments regarding documentation and inquiries
• Maintain positive customer relations and participate in developing department goals and efficiency improvements

Required Qualifications

• Minimum of 2 years of DME experience and/or Utilization Management experience
• High school diploma or GED required
• Proficient with Microsoft Office Suite
• Strong organizational skills and ability to prioritize tasks
• Ability to communicate effectively with various groups