Supports the staff in their day-to-day responsibilities. Ensures clerical activities provide efficiency and organization to the department. Performs duties and tasks in accordance with performance standards established. Plays a key role in ensuring information is released to payers and physician level review. Frequently works with highly sensitive and confidential information.
Job Duties Performs office functions to include but not limited to; answers and triages phone calls, facilitates/assists with calls to insurance companies, maintains and orders supplies and office equipment, collects and verifies information from source documents, either paper or electronic.Serves as a resource to departmental staff regarding insurance contacts.Maintains Utilization management SharePoint site to reflect updated payor information.Demonstrates competency in accessing and documentation in hospital computer systems and programs.Ensures timely notification of admission and discharge in accordance to payor standards.Works in conjunction with the Utilization nurses to ensure timely transfer of information to payers to ensure timely and accurate documentation of authorizations, denials, peer to peer status, physician advisor communication prior to discharge.Performs Release of Information for respective organizations.Communicates all progress, completion or problems on each patient to Utilization Management nurses throughout the work day.Identifies and notifies appropriate staff regarding discrepancy issues with third party payer health insurance coverage and lack of coverage.Serves as a subject matter expert regarding various insurance portals.Exhibits competency and accurate completion for new users and employee alterations.Accurate completion and maintenance of Utilization Management Assistant (UMA) work queue upon conclusion of work day.Ensure right faxes are complete by conclusion of your assigned day of work.Identify and complete mother and baby birth outcomes.Develops and maintains positive relationships between physicians and office staff.Interacts with physicians as needed.
Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.
Geisinger cares about not only its patients and members but also about you and your family. We offer a competitive compensation and benefits package to ensure that you and your loved ones can maintain good health, achieve financial stability, and excel both personally and professionally. We believe in creating a diverse and inclusive environment where all employees can be their authentic selves. To learn more: https://jobs.geisinger.org/diversity
Full benefits (health, dental and vision) starting on day one
Three medical plan choices, including an expanded network for out-of-area employees and dependents
Pre-tax savings plans with healthcare and dependent care flexible spending accounts (FSA) and a health savings account (HSA)
Company-paid life insurance, short-term disability, and long-term disability coverage
401(k) plan that includes automatic Geisinger contributions
Generous paid time off (PTO) plan that allows you to accrue time quickly
Up to $5,000 in tuition reimbursement per calendar year
MyHealth Rewards wellness program to improve your health while earning a financial incentive
Family-friendly support including adoption and fertility assistance, parental leave pay, military leave pay and a free Care.com membership with discounted backup care for your loved ones
Employee Assistance Program (EAP): Referrals for childcare, eldercare, & pet care. Access free legal guidance, mental health visits, work-life support, digital self-help tools and more.
Voluntary benefits including accident, critical illness, hospital indemnity insurance, identity theft protection, universal life and pet and legal insurance.
Education High School Diploma or Equivalent (GED)- (Required) Experience Minimum of 3 years-Healthcare (Required) Skills Teamwork; Group Problem Solving; Multitasking; Communication; Healthcare Industry; Organizing; Office Politics And Confidentiality About GeisingerFounded more than 100 years ago by Abigail Geisinger, the system now includes ten hospital campuses, a 550,000-member health plan, two research centers and the Geisinger Commonwealth School of Medicine. With nearly 24,000 employees and more than 1,700 employed physicians, Geisinger boosts its hometown economies in Pennsylvania by billions of dollars annually. Learn more at geisinger.org or connect with us on Facebook, Instagram, LinkedIn and Twitter.
Our Commitment to Diversity, Equity and InclusionGeisinger values who you are, where you are from, and where you are going. We seek out people of various backgrounds and cultures with unique abilities, non-traditional career paths and ambitious aspirations. We are an Affirmative Action, Equal Opportunity Employer. Women and Minorities are encouraged to apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status. Read more about Our Commitment to Inclusive Recruiting.
Our Vision & ValuesEverything we do is about making better health easier for our patients, our members, our students, our Geisinger family and our communities.
KINDNESS: We strive to treat everyone as we would hope to be treated ourselves.
EXCELLENCE: We treasure colleagues who humbly strive for excellence.
LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow.
INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation.
SAFETY: We provide a safe environment for our patients and members and the Geisinger family.
Our BenefitsWe offer healthcare benefits for full time and part time positions from day one, including vision, dental and prescription coverage.