We’re on a mission to improve health outcomes and reduce the cost of care. The work of our medical department is critical to helping us do both. Working in a call center environment under supervision, this position handles inbound calls from patients, patient representatives, providers, and other medical staff. The schedule for this position is Monday-Friday, 8am-5pm on-site at our company headquarters.
What you’ll add to the team:
Management of precertification processes of eligible medical services based on medical plan documents and medical necessity
Apply clinical knowledge to make determinations for pre-authorizations of specific procedures and services
Conduct Medical/Surgical medical necessity reviews
Verify and update patient information in the clinical information system
Attention to detail and a team-focused attitude
What you’ll bring:
Associates degree or higher
Current LPN certification in North Carolina
Two or more years of healthcare experience and utilization review or related experience preferred
Excellent communication skills with members and providers
Spanish-speaking candidates are preferred
Working at Healthgram:
Healthgram has repeatedly been voted the healthiest mid-size employer in Charlotte, NC. Conveniently located right off of I-77. We offer career advancement opportunities, Medical, Dental, and Vision coverage options, Company paid Life Insurance and LTD, and a Company sponsored 401(k) plan with matching contribution. Incentive based wellness program is top notch – offering onsite massages and daily lunchtime exercise classes. We value what is important to you so we have paid holidays to celebrate and paid time off to recharge.