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

Apply

Vacancy posted 2 days ago

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