INPATIENT UTILIZATION REVIEW TECHNICIAN

HHC•Indianapolis, IN

26d•Onsite

About The Position

Eskenazi Health serves as the public hospital division of the Health & Hospital Corporation of Marion County. Physicians provide a comprehensive range of primary and specialty care services at the 327-bed hospital and outpatient facilities both on and off of the Eskenazi Health downtown campus as well as at 10 Eskenazi Health Center sites located throughout Indianapolis. FLSA StatusNon-ExemptJob Role SummaryThe Inpatient Utilization Review Technician interacts with customers in a caring and respectful manner in accordance with Eskenazi Health Services' Core Values. The Technician acts as a patient information liaison and interfaces with Transitional Support staff, providers and specialists to assist in problem-solving.

Requirements

High school diploma or General Equivalency Diploma (GED)
1-2 years of experience in a healthcare-related position preferred
Knowledge of computer and related software
Medicaid experience preferred
Ability to discern numbers and names, paying specific attention to detail to ensure accuracy in data entry
Works as an effective team member
Knowledge of general office procedures and mandated retention periods for pre-services
Proficiency in document imaging processes, oral and written communications, customer service, and organization

Nice To Haves

1-2 years of experience in a healthcare-related position preferred
Medicaid experience preferred

Responsibilities

Proactively contributes to Eskenazi Health's mission: Advocate, Care, Teach and Serve with special emphasis on the vulnerable population of Marion County. Models Eskenazi's values of Professionalism, Respect, Innovation, Development and Excellence. Interacts with all internal and external customers in a caring and respectful manner in accordance with Eskenazi Health Services' Core Values.
Performs pre-certification activities related to inpatient services in accordance with predetermined departmental criteria.
Acts as a patient information liaison between business partners and contracted vendors.
Handles a variety of confidential data and documentation involving Transition Support Department Utilization Review members, patients and physicians; as well as confidential departmental and hospital information.
Interfaces with Transition Support staff, providers, and specialists to assist in problem-solving.
Maintains open communication regarding current status of departmental operations.
Operates within program requirements in accordance with CMS standards.
Determines validity of coverage following established authorization requirements and refers to the UR Case Manager for further determinations of coverage, as needed.
Compiles data for confidential/statistical reports.
Performs administrative duties for respective work area in a wide variety of non-routine situations.
Receives and screens phone calls, directing them to the UR Case Manager when appropriate.
Responds to inquiries regarding benefits and authorizations, etc.
Receives and maintains departmental files and records.