Utilization Management Assistant

Location:

Work from home (Pennsylvania)

Shift:

Days (United States of America)

Scheduled Weekly Hours:

40

Worker Type:

Regular

Exemption Status:

No

Job Summary:

​In this role, you will support 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.

Position Details:

Education:

High School Diploma or Equivalent (GED)- (Required)

Experience:

Minimum of 3 years-Healthcare (Required)

Certification(s) and License(s):

Skills:

Communication, Group Problem Solving, Healthcare Industry, Multitasking, Office Politics And Confidentiality, Organizing, Teamwork

OUR PURPOSE & VALUES: Everything we do is about caring 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. 

We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, we encourage an atmosphere of collaboration, cooperation and collegiality.

We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all.  We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran.