Utilization Management Technician
About The Position
The Utilization Management Technician provides support to the Utilization Management Department. Performance requires accuracy, attention to detail, initiative, and pro-active approach to duties and responsibilities. The UM Technician works with other support workforce members, and clinical and medical workforce members within a trauma informed and person driven care model to: Process and track Utilization Management related issues in accordance with the Managed Care Organization's guidelines for entering and tracking authorizations, processing completed clinical assessments, and researching denial issues. Responsible for the timely and accurate tracking and entering of service authorizations, including insuring service authorization requests are sent to applicable payers in accordance with UM guidelines. Assist in preparation of regularly scheduled UM/QM reports, as well as reconciling and tracking data from multiple reports, communicating with applicable parties as needed. Prepare and modify documents including correspondence, reports, drafts, memos and emails. Assist in case closures and discharge workflow process. Complete data entry from state database into electronic medical record for clients. Performs other related job duties as assigned.
Requirements
- High school diploma or equivalent (GED). Required
- 2 years’ experience in a medical office setting.
- Basic knowledge of managed care environment.
- Proficient in MS Office with expertise in Microsoft Word, Excel, and PowerPoint.
- Self-starter who consistently meets deadlines, can prioritize, multi-task and be flexible.
- Excellent organizational skills with the ability to prioritize multiple projects.
- Good research skills and attention to detail.
- Ability to write routine reports and correspondence and communicate effectively orally and in writing with a variety of professionals and individuals receiving services/family members.
- Ability to deal with problems involving several concrete variables in standardized situations.
Responsibilities
- Process and track Utilization Management related issues in accordance with the Managed Care Organization's guidelines for entering and tracking authorizations, processing completed clinical assessments, and researching denial issues.
- Responsible for the timely and accurate tracking and entering of service authorizations, including insuring service authorization requests are sent to applicable payers in accordance with UM guidelines.
- Assist in preparation of regularly scheduled UM/QM reports, as well as reconciling and tracking data from multiple reports, communicating with applicable parties as needed.
- Prepare and modify documents including correspondence, reports, drafts, memos and emails.
- Assist in case closures and discharge workflow process.
- Complete data entry from state database into electronic medical record for clients.
- Performs other related job duties as assigned.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
