Utilization Review Liaison
About The Position
Under the general supervision of the Director of Case Management, the Utilization Review (UR) Liaison is responsible for the assisting Utilization Review Case Managers. The UR Liaison is responsible for coordinating insurance reviews and issuance of authorization numbers through submission of required clinical information. The UR Liaison will work directly with all Case Management staff, Business Office, Patient Access, and along with the Hospital’s Revenue Cycle to ensure quality and efficiency of certain elements of claims processing, denial prevention, and denial management. Provides office and referral management support services; assists the Utilization Review Team in obtaining medical records, documenting case information in the system, performing data entry into appropriate databases for monitoring and tracking, and following up on phone calls as directed. Continue to learn about clinical programs, processes, and changes. May also perform office support functions as required. In addition to performing the essential functions listed below, may also be assigned other duties as required.
Requirements
- Assisting Utilization Review Case Managers
- Coordinating insurance reviews and issuance of authorization numbers through submission of required clinical information
- Working directly with all Case Management staff, Business Office, Patient Access, and the Hospital’s Revenue Cycle to ensure quality and efficiency of certain elements of claims processing, denial prevention, and denial management
- Providing office and referral management support services
- Assisting the Utilization Review Team in obtaining medical records
- Documenting case information in the system
- Performing data entry into appropriate databases for monitoring and tracking
- Following up on phone calls as directed
- Continuing to learn about clinical programs, processes, and changes
- Performing office support functions as required
- Performing other duties as assigned
Responsibilities
- Assisting Utilization Review Case Managers
- Coordinating insurance reviews and issuance of authorization numbers through submission of required clinical information
- Working directly with all Case Management staff, Business Office, Patient Access, and the Hospital’s Revenue Cycle to ensure quality and efficiency of certain elements of claims processing, denial prevention, and denial management
- Providing office and referral management support services
- Assisting the Utilization Review Team in obtaining medical records
- Documenting case information in the system
- Performing data entry into appropriate databases for monitoring and tracking
- Following up on phone calls as directed
- Continuing to learn about clinical programs, processes, and changes
- Performing office support functions as required
- Performing other duties as assigned
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
