Utilization Management Intake Coordinator

Arkansas Blue Cross and Blue Shield

Full-time - Entry Level

About the position

The Utilization Management Intake Coordinator I plays a crucial role in supporting clinical, management, and client activities within the Utilization Management (UM) program at Arkansas Blue Cross and Blue Shield. This position requires proficiency in UM processes, including pre-authorizations, claim reviews, triage, and case assignments, ensuring compliance with administrative guidelines and regulatory requirements.

Responsibilities

• Conducts or supports UM system testing as needed.
• Maintains understanding of role-specific regulatory requirements pertaining to UM processes and operations.
• Processes practitioner pre-authorization requests while adhering to administrative guidelines, policies, and procedures.
• Processes prior authorization requests, collecting and transferring non-clinical data and acquiring structured clinical data while adhering to administrative guidelines.
• Supports departmental initiatives such as policy/procedure review, audit preparation, and work instruction updates.
• Performs other duties as assigned.

Requirements

• Associate's degree in a related field with one (1) year of operations experience (health insurance industry preferred) or a minimum of three (3) years' operations experience (health insurance industry preferred).
• Proficiency with MS Office Suite (Word, Excel, PowerPoint) and web-based computer applications.

Nice-to-haves

• Experience in the health insurance industry.
• Strong interpersonal skills.

Benefits

• Tuition reimbursement.
• Access to Club Blue, a free onsite gym.
• Onsite restaurants promoting healthy eating.
• Incentives for wellness education and exercise.