Archived listing. The details below describe a past opening.
We are looking for a detail-oriented Data Entry Clerk to support utilization management operations for a healthcare organization in Westminster, California. This Long-term Contract position focuses on maintaining accurate records, coordinating authorization-related information, and helping ensure requests move through review within required timelines. The ideal candidate is organized, comfortable handling high-volume administrative work, and confident communicating with providers and members to obtain and verify needed information.
Responsibilities:
- Enter, update, and maintain authorization information in internal tracking systems with a high degree of accuracy.
- Communicate by phone with healthcare providers and members to share status updates and obtain missing documentation needed for review.
- Track request due dates and follow established procedures to help meet turnaround time and compliance expectations.
- Upload, sort, and verify clinical and administrative records so files remain complete and easy to access.
- Assist in preparing and processing approval and denial correspondence tied to utilization review activities.
- Maintain daily logs, status reports, and other administrative records that support departmental workflow visibility.
- Route urgent, sensitive, or clinically complex matters to licensed utilization management staff for further review.
- Help organize records and supporting materials for audits, reporting needs, and regulatory submissions.
- Participate in team meetings, training sessions, and other assigned administrative support activities.
- Associate degree or equivalent practical experience in an administrative or healthcare support setting.
- At least 2 years of experience in managed care, health plan operations, prior authorization, or healthcare administration.
- Working knowledge of authorization processes and the importance of meeting required turnaround deadlines.
- Strong data entry, numeric entry, typing, and general computer skills with solid accuracy and speed.
- Proficiency with Microsoft Office and the ability to learn utilization management or case tracking systems.
- Clear written and verbal communication skills for interacting professionally with providers, members, and internal teams.
- Strong attention to detail with the ability to recognize incomplete submissions and request missing information appropriately.
- Bilingual ability in Cantonese, Mandarin, Spanish, Vietnamese, or Korean is preferred.