Utilization and Appeals Data Assistant

divh2Job Title/h2pCH Utilization and Appeals Data Assistant/ph2Job Description/h2pThe CH Utilization and Appeals Data Assistant provides support to the CH Utilization and Appeals Department. The Data Assistant works closely with the Director of Physician Advisors to assist with worklists and scheduling of Peer to Peers. The Data Assistant may also assist with database management including entry of denial correspondence, timely requests for medical records and utilization and appeal follow-up./ph2Specific Responsibilities and Duties/h2pstrongSPECIFIC RESPONSIBILITIES AND DUTIES/strong/pulliManages physician advisor reports and assists with facilitating UM Committee reviews when applicable./liliAssists with and reconciles the case status on the PA list/liliSubmits and tracks R1 cases via the portal/liliAssists with assignment of peer-to-peers/liliCoordinates Peer-to-Peer meetings between physicians and payors./liliNotifies Department Leadership of potential missed timeframes for submission and follow-up on responses and escalates cases as appropriate./liliCoordinates physician schedules/liliAssists with UM/Appeals as needed/liliProvides support for ongoing projects as required/liliMeets productivity standards./liliAttends meetings as required and participates on committees as directed./liliPerforms other related duties as assigned or requested./li/ulh2Position Requirements and Qualifications/h2pstrongEDUCATION/EXPERIENCE/strong/pulliHigh School Diploma or equivalent/lili2 years college preferred./li/ulpstrongSKILLS/strong/pulliSound knowledge and skill in the use of personal computer and software for word processing and spreadsheet required. Experience with EPIC, Midas and other hospital software as required./liliAbility to effectively communicate with all levels of hospital staff in a verbal and written manner; demonstrated ability to be organized and efficient in prioritizing and managing assignments with minimal oversight and direction./liliDemonstrates a courteous and professional demeanor, team spirit and the ability to work in a collaborative, effective manner./liliAbility to utilize critical thinking and apply sound clinical judgment and assessment skills for decision making./li/ulpstrongKNOWLEDGE/strong/pulliMaintains knowledge of requirements by third party payers, regulatory agencies, and managed care entities concerning levels of care, continuity of benefits and medical necessity guidelines./liliKnowledge of managed care and the current standards and trends of patient care, best practices, management tools./li/ulh2Posted Salary Range/h2pUSD $24.00 - USD $30.00 /Hr./ppThis range serves as a good faith estimate and actual pay will encompass a number of factors, including a candidates qualifications, skills, competencies and experience. The salary range or rate listed does not include any bonuses/incentive, or other forms of compensation that may be applicable to this job and it does not include the value of benefits./ppAt Catholic Health, we believe in a people-first approach. In addition to the estimated base pay provided, Catholic Health offers generous benefits packages, generous tuition assistance, a defined benefit pension plan, and a culture that supports professional and educational growth./p/div