Utilization Management Tech - Remote

Software Guidance & Assistance, Inc., (SGA), is searching for an Utilization Management Tech for a contract assignment with one of our premier Healthcare clients in Los Angeles, CA. (100% remote PST hours)

Responsibilities :

• You will receive urgent, routine, pre-service, and retro authorization requests, as well as process prior authorization requests with accuracy and timeliness. This will involve the use of various business applications to perform analysis, obtain information, and enter prior authorization data necessary for claims adjudication. You will use your critical thinking skills to identify missing information and make prior authorization processing determinations based on clinical protocols and other guidelines. You will also interact with internal and external customers to provide and obtain information and ensure the delivery of outstanding service and quality.
  
  

Required Skills:

• Coordinator experience
• Health Plan Experience
• EMR experience
  
  

Preferred Skills:

• EPIC preferred
  
  

SGA is a technology and resource solutions provider driven to stand out. We are a women-owned business. Our mission: to solve big IT problems with a more personal, boutique approach. Each year, we match consultants like you to more than 1,000 engagements. When we say let's work better together, we mean it. You'll join a diverse team built on these core values: customer service, employee development, and quality and integrity in everything we do. Be yourself, love what you do and find your passion at work. Please find us at https://sgainc.com/ .

SGA is an Equal Opportunity Employer and does not discriminate on the basis of Race, Color, Sex, Sexual Orientation, Gender Identity, Religion, National Origin, Disability, Veteran Status, Age, Marital Status, Pregnancy, Genetic Information, or Other Legally Protected Status. We are committed to providing access, equal opportunity, and reasonable accommodation for individuals with disabilities in employment, and our services, programs, and activities. Please visit our company EEO page to request an accommodation or assistance regarding our policy.