Utilization Mgmt Spec

Corewell Health • Southfield, MI

2d • Onsite

About The Position

Under general direction, assists in the provision of the highest service level possible to patients/customers to ensure their satisfaction. Participates in activities with third party payors in order to maximize reimbursement.

Requirements

• Required High School Diploma or equivalent

Nice To Haves

• Post high school training and/or academic coursework leading toward associate’s or bachelor’s degree.
• 2 years of relevant experience healthcare experience.

Responsibilities

• Understands and accesses insurance websites.
• Completes required duties as defined for specific payers to obtain authorization numbers for payment.
• Provides clerical support for Utilization Management; sorting faxes and mail, obtaining authorization numbers, completing follow-up on outstanding cases, and delivery of letters associated with outpatient or inpatient status.
• Utilizes electronic medical record work queues that support Utilization Management functions.
• Answers incoming calls or places outbound calls with appropriate communication skills.
• Triages all calls to the appropriate person for resolution and action or completes appropriate follow-up.
• Problem solves issues that are received via phone, fax or email.
• Other duties as assigned.

Benefits

• Comprehensive benefits package to meet your financial, health, and work/life balance goals.
• On-demand pay program powered by Payactiv
• Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!
• Optional identity theft protection, home and auto insurance, pet insurance
• Traditional and Roth retirement options with service contribution and match savings

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED