We are looking for a detail-focused Data Entry Clerk to support utilization management operations for a healthcare organization in Westminster, California. This Long-term Contract position will help keep authorization activities organized, documented accurately, and completed within required timeframes while working closely with providers, members, and internal utilization management staff. The ideal candidate brings healthcare administrative experience, strong data entry skills, and the ability to manage a high volume of information in a regulated environment.
Responsibilities:
- Enter, update, and maintain authorization-related information in designated systems with a high degree of accuracy.
- Communicate by phone with providers and members to share authorization updates and obtain missing or supporting documentation.
- Track request deadlines and follow established processes to help meet required turnaround standards.
- Upload, categorize, and review clinical and administrative records to confirm files are complete and properly documented.
- Assist with preparing and processing determination correspondence, including approval and denial notices.
- Maintain daily logs, status reports, and activity records to support operational visibility and follow-up.
- Route urgent, sensitive, or clinically complex matters to nurses or medical directors for review and decision-making.
- Help ensure records and workflows align with organizational policies as well as state and contractual compliance requirements.
- Provide support for audits, reporting activities, team meetings, and ongoing departmental training.
- Associate degree or equivalent practical experience required.
- At least 2 years of experience in managed care, health plan operations, prior authorization, healthcare administration, or a related support function.
- Working knowledge of authorization processes and required turnaround expectations in a healthcare setting.
- Strong data entry, typing, and numeric entry skills with consistent attention to detail.
- Ability to handle high-volume tasks while staying organized and meeting deadlines.
- Proficiency with Microsoft Office and systems used for utilization management or healthcare documentation.
- Effective written and verbal communication skills for interacting with providers, members, and internal teams.
- Bilingual ability in Cantonese, Mandarin, Spanish, Vietnamese, or Korean is preferred.