Healthcare Utilization Review Specialist

GeneralGeneralFull TimeRemoteSeniorTeam 51-200H1B No SponsorCompany SiteLinkedIn

Location

Texas

Posted

8 hours ago

Salary

$22 - $24 / hour

Seniority

Senior

Experience acceptedEnglish

Job Description

Healthcare Utilization Review Specialist

Cobalt Benefits Group, LLC (DBA: Blue Benefit Administrators, CBA Blue & EBPA)

• Join our team at Company and build a meaningful career in employee benefits solutions. • Review claims in utilization review queues for medical necessity and authorization status. • Support the daily operations of the Utilization Review department by assisting senior UR team members. • Conduct outreach calls and collect data using established scripts, tools, and protocols. • Process correspondence and faxes in accordance with timeliness standards. • Perform clerical and administrative tasks, including scanning, document retrieval, and urgent claims processing support. • Communicate clearly, professionally, and courteously with internal and external stakeholders. • Provide written direction to other team members to support accurate claims processing. • Maintain current knowledge of Standard Operating Procedures and member benefits. • Ensure compliance with BCBS Association standards and company policies. • Complete other related duties and projects as assigned.

Job Requirements

  • Medical assistant, home health aide, nursing assistant, or other similar health care para-professional training or certification.
  • Fluent computer skills including MS Office (Word, Excel, and Outlook) and Internet applications.
  • Strong reading comprehension
  • Self-motivated, self-directed, operates without constant guidance.
  • Must be able to make sound logical decisions and articulate the reasoning.

Benefits

  • Fantastic medical, dental, and vision insurance*
  • Twice annual employer HSA contributions, covering 50% of the HDHP plan’s annual deductible!
  • Company provided Basic Life and AD&D
  • Company paid Short-Term and Long-Term Disability**
  • Flexible Spending Accounts*
  • 401(k) Retirement Plan with up to a 6% employer-match**
  • WOW! (100% fully vested after 3 years)
  • 10+ paid holidays
  • Generous paid vacation and sick time
  • Annual Volunteer Paid Day
  • Annual Tuition Reimbursement
  • Annual Health and Wellness Reimbursement
  • Lots of fun company events

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