Review Coordinator II

Medica's Review Coordinator II is responsible for coordinating and supporting all intake functions into the Utilization Management and Clinical Appeals Department in accordance with all department policies, regulatory and accreditation requirements.

Key Elements:

• Triage, research and enter acute inpatient hospital admissions and outpatient medical prior authorization requests
• Triage, research and enter member administrative referrals
• Triage, research and complete non-clinical service requests
• Outreach attempts to providers requesting clinical or additional information needed for the requested reviews
• Research and resolution of provider and member questions and issues while maintaining a positive customer relationship

This is a critical role at Medica, as downstream activities, depend upon the timely, accurate processing of information to perform their job functions.

Qualifications:

• High School Diploma or Equivalent; Associate's or Bachelor's degree preferred
• 2+ years of healthcare industry experience within a professional customer service or administrative type function

Skills and Abilities:

• Knowledge of prior authorization or hospital admission processes preferred, however not required
• Advanced data entry skills
• Strong verbal and written communication
• Strong organizational and time management skills
• Ability to manage multiple tasks and priorities
• Analytical and critical thinking skills
• Ability to work with limited supervision
• Attention to detail and accuracy are critical
• Excellent computer skills

This position is a Remote role and will work remotely 100% of the time. To be eligible for consideration, candidates must have a primary home address located within any state where Medica is registered as an employer - AR, AZ, FL, GA, IA, IL, KS, KY, MD, ME, MI, MN, MO, ND, NE, OK, SD, TN, TX, VA, WI.

The full salary range for this position is $40,500-$69,400. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to compensation, Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees.

The compensation and benefits information is provided as of the date of this posting. Medica's compensation and benefits are subject to change at any time, with or without notice, subject to applicable law.

We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.