Utilization Management Assistant

Authorization Support: Assist in obtaining authorization and continued stay authorizations from insurance companies.

Data Management: Track and distribute fax communication and upload documents from insurance portals into HER.

Communication: Serve as a liaison between providers, patients, payers and internal departments to facilitate utilization management services.

Documentation: Maintain accurate records of authorization, denials, appeals, and other UM activities as needed.

Policy Adherence: Follow UM policies and procedures, escalating issues when necessary.

Customer Service: Complete administrative duties which may include fax distribution, answer telephone inquiries and forwarding to the appropriate team members.

Required Education:High School Diploma or equivalent

Preferred Education:Some college level education

Licensing/ Certification

Licensure/Certification Required:N/A

Licensure/Certification Preferred:N/A

Minimum Qualifications

Years and Type of Required Experience: One (1) year of experience in an acute care academic medical center or comparable organization

Other Knowledge, Skills and Abilities Required:Knowledge of computers and various computer programs such as Microsoft Suite products [Word, Excel, and Adobe Professional]

Other Knowledge, Skills and Abilities Preferred:Effective communication skills, both verbal and written. Strong organization skills, follow-through abilities and time management skills. Solid problem solving and decision-making skills. Demonstrated flexibility and assertiveness. Skills in establishing and maintaining cooperative and "team" oriented working relationships with others.

Working Conditions: Periods of high stress and fluctuating workloads may occur. May have periods of constant interruptions. Prolonged periods of working alone.

Physical Requirements

Physical Demands: N/A

Work Position: Sitting