Certification Specialist - Utilization Management

Kettering Health • Miamisburg, OH

1d • Remote

About The Position

Kettering Health is a not-for-profit system of 13 medical centers and more than 120 outpatient facilities serving southwest Ohio. We are committed to transforming the health care experience with high-quality care for every stage of life. Our service-oriented mission is in action every day, whether it’s by providing care in our facilities, training the next generation of health care professionals, or serving others through international outreach.

Requirements

• Minimal high school graduate.

Nice To Haves

• Associate Degree preferred

Responsibilities

• Certification review at Kettering Health Network hospitals.
• Follow-up with insurance companies - approvals, denials, requests for additional information
• Assist in facilitating peer to peer reviews
• Verification of discharge
• Works closely with other disciplines - specifically Insurance Verification, Patient Access, Denials Management, Case Management and Social Services.
• Routinely works with large volume of patient accounts.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED