Utilization Review Assistant

Utilization Review Assistant

We are currently seeking a full time Utilization Review Assistant to join our team.

Job Summary:

This position is responsible for taking the data provided to their department and using it to communicate necessary information to both the Utilization Review Representatives and our clients. Making sure that all necessary information is communicated to the appropriate party in a timely fashion is imperative so that the patients are able to receive the proper level of care and to help ensure coverage for care by the insurance company. Day-to-day responsibilities may vary.

Job Duties and Responsibilities:

Core duties and responsibilities include but are not limited to the following. Other duties may be assigned as necessary.

  • Establish and maintain positive and effective communication with UR Representatives to ensure daily caseload is worked successfully.
  • Establish and maintain positive and effective communication with clients to ensure understanding of all individual patient cases.
  • Create and send out NDA’s to clients each day.
  • Review incoming OR Reports to ensure they are in compliance with NDA’s.
  • Create Billing Tasks.
  • Request and obtain patient pertinent health information.
  • Detailed system documentation of accounts.
  • Communicating with other departments to obtain or provide needed information on an account.
  • Special Projects as needed.

Required Education and Experience:

  • 2 – 5 years administrative experience in medical facility or related field.
  • 2 – 5 years of experience in Customer Service or related environment preferred.
  • High school diploma or GED equivalent.

Required Knowledge, Skills, and Abilities:

  • Knowledge of CPT, ICD 9 & ICD 10 coding, medical terminology, and EMR Systems.
  • Proficiency in Microsoft Office Applications including Excel, PowerPoint, and Word.
  • Knowledge of HIPAA regulations and guidelines.
  • Must be organized, detail oriented, and have the ability to multitask.
  • Excellent verbal and written communication skills.
  • Critical thinking and problem solving skills.
  • Must be able to work in a team environment.
  • Behavioral health knowledge is a plus.

Compensation and Benefits:

  • Competitive market-based salary, salary commensurate with experience.
  • Benefits package available.

How To Apply:

Email resume with salary history and a cover letter to be considered.