Medical Authorizations

My client, a healthcare company located in the Doral area, has an immedicated opening for a Care Review Coordinator for their Utilization Management deparment.

This individual will be working closely with the Utilization Review team to provide clerical and data entry support for persons that require hospitalization and/or utilization review for other healthcare services.

Main Responsibilities:

• Checks eligibility and verifies benefits
• Obtains and enters data into systems,
• Processes requests, and triages members and information to the appropriate Care Services staff to ensure the delivery of high quality, cost-effective healthcare services.

Necessary Qualifications:

• Provide computer entries of authorization request/provider inquiries by phone, mail, or fax.
• Verify member eligibility and benefits.
• Determine provider contracting status and appropriateness.
• Determine diagnosis and treatment request
• Assign billing codes (ICD-9/ICD-10 and/or CPT/HCPC codes),
• Determine COB status,
• Verify inpatient hospital census-admits and discharges.
• Perform action required per protocol using the appropriate Database.
• Provide excellent customer service for internal and external customers.
• Notify Care Access and Monitoring Nurses and case managers of hospital admissions and changes in member status.
• Meet productivity standards.
• Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
• Participate in Care Access and Monitoring meetings as an active member of the team.
• Follow Standards of Conduct guidelines.
• Comply with required workplace safety standards.

Knowledge/Skills/Abilities:

• Demonstrated ability to communicate, problem solve, and work effectively with people.
• Working knowledge of medical terminology and abbreviations.
• Ability to think analytically and to problem solve.
• Good communication and interpersonal/team skills.
• Must have a high regard for confidential information.
• Ability to work in a fast paced environment.
• Able to work independently and as part of a team.
• Computer skills and experienced user of Microsoft Office software.
• Accurate data entry at 40 WPM minimum.

If interested, please send resumes for immediate consideration.

About Aerotek:

Aerotek, headquartered in Hanover, Md., is a leading provider of technical, professional and industrial staffing services. Established in 1983, Aerotek is an operating company of Allegis Group, the largest provider of staffing services in the U.S. Aerotek operates a network of more than 200 non-franchised offices throughout the U.S., Canada and Europe. For more information, visit .

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please call 844 895-8598 or email . However, if you have questions about this position, please contact the Recruiter located at the bottom of the job posting. The Recruiter is the sole point of contact for questions about this position.