Utilization Management Assistant
Utilization Management Assistant
Posted on :
14-06-2025
Employer Active
1 Vacancy
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Job Description
Overview
CHI Health Immanuel located in North Omaha just off of I-680 on 72nd Street offers a full-service hospital cancer center rehabilitation center specialty spine hospital and more. For well over a century our commitment to serve our community inspires our staff to provide the highest quality of care to all who we have the privilege to serve.
Responsibilities
- Receives sends and documents payer requests for clinical documentation.
- Receives and documents payer authorization and communications including but not limited to concurrent denials.
- Coordination of peer to peer conversations as applicable.
- Reviews surgery schedule to verify correct authorization is documented if applicable.
- Identifies accounts lacking authorization and follows up with payers as needed.
- Communicates with interdepartmental staff regarding payer documentation requests.
- Under RN direction submits requests for and follows up on administrative days authorization where indicated.
- Identifies and reports trends to department Leadership.
- Utilizes payer related reports from Care Management software where applicable.
- Collaborates with and supports the UM team including but not limited to UR and Denials RN.
- Contributes to the identification of opportunities for process improvement.
- Supports administrative departmental functions as assigned.
Qualifications
- Minimum one year experience in a hospital physicians office or medical group performing duties related to admitting business office payer communications or managed care or an equivalent combination of education and experience
- High school diploma or GED required
Preferred
- An understanding of operations and functions of care coordination utilization management denials mitigation is preferred.
Employment Type
Unclear
Key Skills
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