Healthcare Utilization Specialist

hace 1 semana


Medellín, Antioquia, Colombia Third Way Health, Inc. A tiempo completo

At Third Way Health, Inc., we're dedicated to enhancing the healthcare experience for patients and providers across the United States.

About the Position

We're seeking a highly skilled Healthcare Utilization Specialist to join our team in the Medellin area. As a valued member of our team, you'll play a crucial role in streamlining healthcare processes and ensuring compliance with regulations.

Key Responsibilities:
  • Conduct thorough prior authorization and retrospective reviews for elective inpatient admissions, outpatient procedures, post-homecare services, and durable medical equipment.
  • Maintain open communication with stakeholders to ensure seamless process execution.
  • Stay updated on state and federal regulations, as well as accreditation standards, to guarantee compliance.
  • Develop and implement efficient operational processes to uphold quality standards within the team.

Required Skills and Qualifications:

  • University or associate degree preferred.
  • At least 8 months of experience in health insurance.
  • Fluency in English and Spanish (C1 level or above).
  • Expertise in managing call center operations and adapting to fast-paced environments.
  • Patient and empathetic attitude, with strong time management and organizational skills.

The estimated annual salary for this position is $60,000 - $80,000, depending on qualifications and experience. If you're passionate about improving the healthcare experience, we encourage you to apply.



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