Associate Care Management Coordinator - (Remote)

**Company :**
Highmark Inc.
**Job Description :**

**JOB SUMMARY**

Perform accurate and timely processing of pre-certification requests for authorization of medically necessary health care services at the appropriate level of care, based on the benefits for the line of business, and in compliance with the organization's policies, procedures and regulatory requirements. Document, process and route requests for services to the nurse reviewer and other departments based on documentation procedures, including review type, clinical information, and decision timeframes. Follow policies and procedures to assure case completion and compliance with state and federal regulatory agencies. Maintain or exceed department standards for call volume, response time and related production and quality measures. May interact with other departments and providers to resolve cases.

**ESSENTIAL RESPONSIBILITIES:**

+ Communicate effectively
+ Proactively inform desig...