Utilization Management CNA
About The Position
Utilization Management Assistant Location : Onsite in Dubuque, IA. Also accepting remote applicants. Are you passionate about patient care and thrive in a fast-paced, professional environment? We are seeking a dedicated Utilization Management Assistant to join our healthcare team. We are looking for individuals with experience in a medical setting, including but not limited to a receptionist, scheduler, insurance verification, LPN, CNA, Medical Assistants, or individuals with a background in customer service who are looking to make a meaningful impact behind the scenes. If you are looking to get into a professional office setting with daytime office hours and weekends/holidays off , this is the role for you! The Utilization Management Assistant answers first level calls in Utilization Review for our Health & Wellness participants. They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. Y ou will be responsible for reviewing medical records, coordinating with healthcare providers, and ensuring that patients receive appropriate, cost-effective care in accordance with clinical guidelines and insurance requirements.
Requirements
- CNA, LPN, or Medical Assistant preferred
- Background in patient health support or care
- 1+ years of experience within this field
Nice To Haves
- Communication - Strong interpersonal skills to be able to connect with patients, doctors, internal team members, and providers
- Customer Service - Friendly demeanor and understanding to be able to relay sensitive information to members
- Detail Oriented - Accuracy and attention to detail when reviewing pre-certifications and plans
Responsibilities
- Answering first level calls in Utilization Review
- Evaluating certification requests by reviewing group specific requirements
- Triage calls to determine if a Utilization Review Nurse is needed
- Reviewing medical records
- Coordinating with healthcare providers
- Ensuring patients receive appropriate, cost-effective care in accordance with clinical guidelines and insurance requirements
Benefits
- Medical, Dental, Vision Insurance
- Flex Spending or HSA
- 401(k) with company match
- Profit-Sharing/Defined Contribution (1-year waiting period)
- PTO/Paid Holidays
- Company-paid ST and LT Disability
- Maternity Leave/Parental Leave
- Subsidized Parking
- Company-paid Term Life/Accidental Death Insurance
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
