Utilization Management Assistant

Franciscan Alliance, Inc. • Central, IN

3d • Hybrid

About The Position

The Utilization Management Assistant performs secretarial or clerical functions to support the administrative operations of the Utilization Management department. This position assists by reviewing and scanning prior authorization forms into the electronic medical record system, reviewing and working the high volume of faxes received on a daily basis from payers, reviewing surgery schedules, and requesting authorization for services. WHO WE ARE With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve. WHAT YOU CAN EXPECT Schedule: Monday - Friday, 9:30am - 6pm EST Hybrid role that will require reporting to the office once a week.

Requirements

• High School Diploma/GED required
• 1 year of clerical/office experience required

Nice To Haves

• 1 year of hospital experience preferred

Responsibilities

• Obtain status details regarding care authorizations and supervisory visit requirements from insurance payers.
• Follow payer processes (website, fax, contact number) to submit appropriate clinical documentation.
• Remain current on updates from payers to ensure appropriate reimbursement from payers.
• Collect clinical information regarding services to be rendered for prior authorizations.
• Contact payers to obtain prior authorizations.
• Enter standardized documentation within electronic medical record to identify prior authorization and the criteria surrounding each authorization.
• Educate collaborative multi-disciplinary teams regarding the prior authorization process.
• Advise providers and their clinical staff when issues arise relating to obtaining prior authorization.
• Complete administrative duties which include answering telephone calls and directing them to the appropriate team member if needed, reviewing incoming faxes, manually fax if system is down, provide support to the nurses on the team.
• Process prior authorization forms.
• Respect the sensitive nature of correspondence and consistently maintain confidentiality.
• Assist in the onboarding and training of new coworkers to ensure all coworkers receive consistent and accurate information.

Benefits

• Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees