Healthcare Utilization Specialist

hace 3 semanas


Medellín, Antioquia, Colombia Third Way Health A tiempo completo

About Third Way Health:

We are a leading healthcare technology platform that helps medical practices and healthcare organizations improve patient experience while reducing administrative burden.

Our Mission:

We strive to support physicians and provide patients with a better healthcare experience, regardless of their background.

Job Description:

In this role, you will perform prior authorization verification and retrospective reviews for elective inpatient admissions, outpatient procedures, post-homecare services, and durable medical equipment. You will also make necessary calls to ensure all parties are aligned throughout the process.

Responsibilities:

  • Conduct thorough reviews to ensure compliance and appropriate utilization.
  • Make timely and accurate decisions for complex cases.
  • Stay updated on state and federal regulations and accreditation standards.
  • Foster effective communication with all stakeholders.
  • Log cases accurately in software platforms to track and manage healthcare processes.

Requirements:

  • University or associate degree preferred.
  • At least 8 months of experience in health insurance.
  • Strong communication skills (fluent in English and Spanish).
  • Expertise in healthcare and managing call center operations.
  • Great active listening skills.
  • A patient and empathetic attitude.
  • Strong time management and organizational skills.
  • Adaptability and flexibility.
  • Comfortable working in fast-paced environments.

Compensation:

The estimated salary for this position is $45,000 - $60,000 per year, depending on experience and qualifications.



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