POSITION SUMMARY

The Utilization Management Support Staff role provides administrative support to the Utilization Management staff. This position is primarily responsible for assisting the Utilization Review Coordinators to obtain authorization from the payers for the patients' hospital stays at the appropriate level of care, and to prevent a potentially denied hospital stay. Some specific tasks of this role include faxing clinical information to the payers in order to obtain an authorization, daily monitoring of various payer logs and submitting the requested information as directed by Utilization Review Coordinators, providing prompt feedback to both the Utilization Review Coordinators and the Physician Advisor if an authorization is not obtained, and documenting the various payer communications in the Care Management Tool.

This position requires daily collaboration/interaction with all Utilization Management staff, regular communication with the Physician Advisor, and ongoing collaboration with some of the Revenue Cycle team. This position requires a strong knowledge of medical terminology and the various payers' authorization processes. This position supports organizational goals by providing quality customer service, participating in performance improvement efforts and demonstrating a commitment to team work and cooperation.

QUALIFICATIONS

EDUCATION: High School Diploma required. Associate's Degree preferred.

EXPERIENCE: Minimum 3 years of administrative experience required. Medical Terminology knowledge and payer authorization processes required. Strong effective communication skills, excellent organizational and time management skills, and flexibility in responding to multiple demands are required. 3 years of Patient Care Technician, Medical Assistant, or Administrative Associate experience preferred.

PERFORMANCE EXPECTATIONS

Consistently demonstrates the technical and behavioral competencies as established on the Assessment and Evaluation Tool.

 WORK ENVIRONMENT

Office environment with limited exposure to infectious disease, hazardous substances and potential injury. This position requires desk/computer work a majority of the time.

REPORTING RELATIONSHIP

This position reports to department leadership.