Utilization Review Assistant

Job Description The Utilization Review Assistant is responsible for the administrative components of Utilization Management that primarily focuses on supporting the medical review process. The Utilization Review Assistant is responsible for the administrative components of Utilization Management that primarily focuses on supporting the medical review process. Responsibilities Responsible for communication of required healthcare documents to patients and/or representatives. Adhere to regulatory and compliance standards Understanding benefits including Medicaid and Medicare Work closely with utilization review staff, care managers and social workers to assist with any administrative responsibilities or needs. Documentation entry Phone and Voicemail retrieval Mail distribution within the department Worklist management Other duties assigned Education H.S. Diploma - or GED - Required Work Experience Experience in healthcare, managed care, hospital, or clinical setting, or other comparable work experience. - Preferred Licenses and Certifications Upon Hire Travel Requirements Travel to off-site locations may be required. - Required Skills and Abilities Hand/eye coordination: speaks clearly; good hearing, ability to use computers, printers and telephone equipment Interpersonal skills Ability to work as a member of a team and develop trusting relationships quickly Excellent verbal and written communication skills including sensitivity to other cultures and ethnicities. Essential Technical/Motor Skills Essential Technical/Motor Skills Essential Mental Abilities Implements and provides ongoing support of members care plan, recognizes alternatives, identifying problems. Provides patient and family teaching about health related needs, financial needs and other coping issues. Concentrates on plans and roles of other team members, understanding all responsibilities and plans. Essential Sensory Requirements Visual and hearing skills to obtain a driver’s license are required. Ability to communicate with members and families, communicating in person and on phone. Exposure to Hazards Exposure to Hazards Other Skills And Abilities Must have access to transportation #J-18808-Ljbffr