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Utilization Review Assistant

Mosaic Life Care

Job Description

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

Qualifications

Skills and Abilities

Essential Technical/Motor Skills
  • 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.
Interpersonal Skills

Essential Physical Requirements

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

Other Skills and Abilities
  • Must have access to transportation
Vacancy posted 1 day ago
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