Utilization Management Assistant
About The Position
The CommonSpirit Utilization Management Assistant receives, processes, facilitates and documents all payer communications. This position supports denial mitigation by sending documentation within the contracted time period, following up on accounts lacking authorization and communicating with internal stakeholders to ensure the accurate submission of clinical documentation to third party payers. The Utilization Management Assistant supports the Utilization Management Hub department by recognizing trends and opportunities for process improvement and reporting those to leadership. The Utilization Management Assistant performs these duties with a high degree of accuracy utilizing critical thinking skills and in compliance with hospital policies, standards of practice and Federal and State Regulations.
Requirements
- 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
- High school diploma or GED required
Nice To Haves
- An understanding of operations and functions of care coordination, utilization management, denials mitigation is preferred.
Responsibilities
- Receives, processes, facilitates and documents all payer communications.
- Supports denial mitigation by sending documentation within the contracted time period.
- Follows up on accounts lacking authorization.
- Communicates with internal stakeholders to ensure the accurate submission of clinical documentation to third party payers.
- Supports the Utilization Management Hub department by recognizing trends and opportunities for process improvement and reporting those to leadership.
- Performs duties with a high degree of accuracy utilizing critical thinking skills and in compliance with hospital policies, standards of practice and Federal and State Regulations.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
