Deskripsi Pekerjaan
Join Lunas Solution Corp. as a Healthcare Utilization Review Analyst and make a meaningful impact in the healthcare sector. This full-time position offers the opportunity to work in a dynamic environment where your analytical skills and healthcare knowledge will be valued. As part of our dedicated team, you'll handle prior authorization processes, ensuring compliance with healthcare regulations while delivering exceptional service to patients and providers. We offer competitive compensation, comprehensive benefits, and a supportive workplace culture that fosters professional growth. If you're passionate about healthcare excellence and possess strong communication abilities, this role is your chance to advance your career in a reputable organization.
Tanggung Jawab
- Conduct thorough utilization reviews for prior authorization requests
- Analyze medical necessity and treatment plans against established guidelines
- Collaborate with healthcare providers to obtain additional documentation
- Ensure compliance with healthcare regulations and organizational policies
- Document review outcomes with precision and attention to detail
- Communicate authorization decisions to stakeholders professionally
- Continuously update knowledge of healthcare regulations and procedures
Kualifikasi
- Experience in healthcare utilization review or prior authorization processes
- Strong analytical skills with attention to detail
- Excellent verbal and written communication abilities
- Familiarity with healthcare regulations (e.g., HIPAA, PHI)
- Ability to work independently and collaboratively in a team
- Proficiency in healthcare software and documentation systems
- Customer service orientation with problem-solving mindset
- High school diploma; healthcare certification preferred