Utilization Management Assistant (Full-time)

UHS•West Allis, WI

12h

About The Position

Granite Hills Hospital offers high-quality, patient centered behavioral health care for the greater Milwaukee community. Our 120-bed facility will feature evidence-based treatment for adolescents, adults, and older adults. We are seeking a Utilization Management Assistant for the Utilization Management Department. If you're passionate about working in the behavioral health setting and have the desire to join a team of healthcare professionals dedicated to serving our patients, we want to hear from you! The Utilization Management Assistant (UMA) provides administrative support to the Utilization Management (UM), departments. The UMA performs clerical duties including but not limited to: Notification of Admission of hospitalizations, distribution of incoming authorization requests, maintaining the electronic filing system, monitoring, conducting fax, email, online payer databases, voicemail coverage, discharge notifications, determinations, etc in the UM department following established standards and practices, adhering to UM polices and standards. Granite Hills Hospital offers comprehensive benefits such as: Competitive Compensation Excellent Medical, Dental, Vision, and Prescription Drug Plan Generous Paid Time Off 401(K) with company match and discounted stock plan Career development opportunities within UHS and its Subsidiaries Education Assistance Challenging and rewarding work environment Interested applicants may apply directly through our website https://granitehillshospital.com/ and apply through the Careers tab. One of the nation’s largest and most respected hospital companies, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Steadily growing from a startup to an esteemed Fortune 500 corporation, UHS today has annual revenue nearing $10 billion. UHS is recognized as one of the World’s Most Admired Companies by Fortune; ranked #276 on the Fortune 500, and listed #275 in Forbes inaugural ranking of America’s Top 500 Public Companies.

Requirements

High school diploma or GED required AA/ BA preferred.
One (1) years of medical office or health insurance experience required OR Two (2) years’ experience working in mental health setting and previous secretarial experience preferred.
Solid verbal, written and interpersonal communication skills required.
Demonstrated customer service skills required.
Excellent organization skills, with attention to detail and follow through.
Ability to meet and/or exceed all established performance standards on a consistent basis (i.e., regulatory timeframes, accuracy, and quality).
MS Office including Word, Excel, and Outlook in a Windows based environment and an ability to quickly learn new systems.
Successful completion of CPI training including de-escalation and appropriate use of seclusion and restraint, within the first 30 days of employment and required prior to assisting in the procedures.
Obtain CPI instructor certification within 6 months of hire.

Responsibilities

Extracts necessary admission and discharge records from the hospital medical record and other electronic applications and accurately enters records/data communicating as a bridge between insurance payers and the hospital UM department with a goal of supporting the procurement of hospitalization authorizations.
PDF’s and places in electronic file re-authorization requests with supporting documentation and insurance verification, assigns patient files to the appropriate utilization review clinicians.
Faxes completed re-authorization forms to the appropriate agencies, obtains fax confirmation and files both with supporting documentation in the patient charts.
Sorts additional information received from the staffing department, pulls patient charts and delivers all to the appropriate UM Coordinator.
Ensures smooth UM department functioning while working in tandem with the UM team, Health Information Management and Physicians. Responsibilities include but are not limited to working with payer-based web systems (Acentra Health aka Kepro), answering phones/voicemails, communicating effectively and professionally through both written and verbal means, demonstrating proficiency with use of various electronic applications (Midas, MS4), providing appropriate & accurate documentation related to hospitalization authorization and running daily reports.
Accurately processes and documents incoming and outgoing communication in all forms in the hospital EMR or payer-specific web-based systems. Communicates time-sensitive information to UM Team and Business Office counterparts. Escalates challenges to leadership as needed. Involves payer-based supervisory staff when warranted.
Communicates and documents all conversations with internal and external key stakeholders according to departmental policy and procedure.