Utilization Management Assistant

About the role

As our Utilization Management (UM) Assistant, you will provide essential administrative and clerical support to the UM team, playing a crucial role in maintaining efficient and organized operations. Every day you will manage documentation, process incoming requests, facilitate communication between team members and external parties, and assist with data entry and record-keeping to ensure smooth UM workflows.

Responsibilities

• Receives, sends and documents payer requests for clinical documentation
• Receives and documents payer authorization and communications including but not limited to concurrent denials
• Coordination of peer to peer conversations, as applicable
• Reviews surgery schedule to verify correct authorization is documented, if applicable
• Identifies accounts lacking authorization and follows up with payers, as needed
• Communicates with interdepartmental staff regarding payer documentation requests

Requirements

• Minimum one year experience in a hospital, physician's office, or medical group performing duties related to admitting, business office, payer communications or managed care or an equivalent combination of education and experience, upon hire
• High School Graduate or GED

Qualifications

To be successful in this role you will possess excellent organizational skills, a keen eye for detail, strong communication abilities, and a proactive approach to supporting the daily functions of the Utilization Management department.

Pay

$19.87 - $28.06 /hour