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.

Responsibilities

• 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
• Receive, send and document payer requests for clinical documentation
• Receive and document payer authorization and communications including but not limited to concurrent denials
• Coordinate peer to peer conversations, as applicable
• Review surgery schedule to verify correct authorization is documented, if applicable
• Identify accounts lacking authorization and follow up with payers, as needed
• Communicate with interdepartmental staff regarding payer documentation requests

Qualifications

• 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

Skills

• Excellent organizational skills
• Keen eye for detail
• Strong communication abilities
• Proactive approach to supporting the daily functions of the Utilization Management department

Pay

$19.87 - $28.06 /hour