Job Description
**Company :**
Highmark Inc.
**Job Description :**
**JOB SUMMARY**
This job is responsible for completing all Prior Authorization outbound call tasks and/or inbound triage case creations. In compliance with regulatory guidelines (e.g., NCQA, CMS), the incumbent informs the member and/or provider of the approval and/or denial of the requested authorization.
**ESSENTIAL RESPONSIBILITIES**
+ Obtain call task from Utilization Management platform, perform verbal outbound call task requirement following a detailed script and desk level procedure, and appropriately log result within the platform.
+ Obtain triage task from Utilization Management platform and follow a detailed desk level procedure to enter the required fields to set up the case build (data entry) and set the urgency of the case creation for the Intake Coordinator.
+ Other duties as assigned or requested.
**EXPERIENCE**
**Required**
+ None
**Pref...
Highmark Inc.
**Job Description :**
**JOB SUMMARY**
This job is responsible for completing all Prior Authorization outbound call tasks and/or inbound triage case creations. In compliance with regulatory guidelines (e.g., NCQA, CMS), the incumbent informs the member and/or provider of the approval and/or denial of the requested authorization.
**ESSENTIAL RESPONSIBILITIES**
+ Obtain call task from Utilization Management platform, perform verbal outbound call task requirement following a detailed script and desk level procedure, and appropriately log result within the platform.
+ Obtain triage task from Utilization Management platform and follow a detailed desk level procedure to enter the required fields to set up the case build (data entry) and set the urgency of the case creation for the Intake Coordinator.
+ Other duties as assigned or requested.
**EXPERIENCE**
**Required**
+ None
**Pref...
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