Performing redirections for our non-par auth requests.
When our team gets a request from a provider who is not contracted with Ambetter our team must attempt to find an in-net-work provider to redirect the member to and document this in the authorization.
Will be making phone calls and talking to provider offices to see if they can accept the member.
Describe the performance expectations/metrics for this individual and their team:
Once trained they should be able to redirect 15-17 auths per day.
Job Description
Yes, but these are the Job description updated by Hiring manager what experience he is looking in candidate, so below are the updated job description:
Walk me through the day-to-day responsibilities of this the role and a description of the project:
Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case findings.
Describe the performance expectations/metrics for this individual and their team:
Once trained they should be able to process 15-17 auths per day.
Required Skills/Experience:
LVN/LPN/RN 6 months or more
Seniority level
Entry level
Employment type
Full-time
Job function
Health Care Provider
Industries
Staffing and Recruiting
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