**Responsibilities:** + Electroniclogging of documentation and subsequent notification to downstream entities including Utilization Management (UM), Care Management (CM) or other teams. Ensure that the input information is correct and complete, includingmember/provider information, medical records, and Protected Health Information (PHI). + Data entry of authorization requests including location of services, medical diagnoses, and service codes; Telephonic outreach to providers or collaboration with UM Management required in some instances to confirm provider request information. + Telephonic support to the UM team with the process of member and provider notification of both favorable and adverse determinations for authorizations created within the RightFax department. + Electronic logging of all critical incoming fax documentation to ensure regulatory compliance adherence. These include, but are not limited to, expedited authorization requests, pharmacy requests, skilled nursing facility requests, homecare requests, and any other documentation with stringent regulatory time frames. + Cross departmental collaboration to investigate and solve operational issues as well as ensure that process design is working appropriately and accurately. Cooperation with UM, CM, Clinical Information Analyst, Regulatory and Compliance, Legal, Claims, Call Center Operations, Enrollment and Billing, and others as needed. + Development of job aids and training material for the RightFax and HIE teams, as well as peer to Peer education. + Attend virtual meetings with outside organizations to promote and educate on HIE material and process. + Point of contact for vendor managers to assist in re-education of Healthfirst providers. + Additional duties as assigned **Minimum Qualifications:** + Minimum 3 years experience in the healthcare field with knowledge of Medical Terminology. + Ability to execute and reconcile a high volume of data entry. + Ability to prioritize and follow through on assigned tasks with minimal oversight. + Administrative or clerical experience on various computer applications. + Minimum High school diploma or GED. **Preferred** **Qualifications:** + Associates degree preferred. + Astute attention to detail, critical thinking skills, and analytical mindset. + Interpersonal skills. + Previous experience working with cross-functional teams. WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.