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.<br><br>Responsibilities:<br>• Enter, update, and maintain authorization information in internal tracking systems with a high degree of accuracy.<br>• Communicate by phone with healthcare providers and members to share status updates and obtain missing documentation needed for review.<br>• Track request due dates and follow established procedures to help meet turnaround time and compliance expectations.<br>• Upload, sort, and verify clinical and administrative records so files remain complete and easy to access.<br>• Assist in preparing and processing approval and denial correspondence tied to utilization review activities.<br>• Maintain daily logs, status reports, and other administrative records that support departmental workflow visibility.<br>• Route urgent, sensitive, or clinically complex matters to licensed utilization management staff for further review.<br>• Help organize records and supporting materials for audits, reporting needs, and regulatory submissions.<br>• Participate in team meetings, training sessions, and other assigned administrative support activities.
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.<br><br>Responsibilities:<br>• Enter, update, and maintain authorization-related information in designated systems with a high degree of accuracy.<br>• Communicate by phone with providers and members to share authorization updates and obtain missing or supporting documentation.<br>• Track request deadlines and follow established processes to help meet required turnaround standards.<br>• Upload, categorize, and review clinical and administrative records to confirm files are complete and properly documented.<br>• Assist with preparing and processing determination correspondence, including approval and denial notices.<br>• Maintain daily logs, status reports, and activity records to support operational visibility and follow-up.<br>• Route urgent, sensitive, or clinically complex matters to nurses or medical directors for review and decision-making.<br>• Help ensure records and workflows align with organizational policies as well as state and contractual compliance requirements.<br>• Provide support for audits, reporting activities, team meetings, and ongoing departmental training.