Wellforce Utilization Review Authorization Specialist in Lawrence, Massachusetts
The UR Authorization Specialist assists with the coordination of managed care patients, follows procedures to obtain needed authorizations, documents necessary authorization/utilization information in patient electronic medical record, tracks appropriate utilization of services and has knowledge of reimbursement guidelines.
Required Education and Experience
Knowledge of insurance authorization/utilization process required.
Knowledge of in networks and out-of-network-payers, Medicaid, Medicare, and commercial plans preferred.
Coordination of benefits knowledge preferred.
Exceptional documentation, communication and organizational skills.
Associate’s Degree Preferred.
Computer literacy required.
Good customer Service Skills.
Ability to read/write and communicate in English.
Excellent interpersonal skills.
Ability to function well in very busy situations.
Responsible and reliable.
Good organization skills.