Assistant, Utilization Review PRN
City/State: Fredericksburg, Virginia
Category: Support Services
Position Hours: 4Apply
Position Shift: Day (United States of America)
Job Requisition Number: R-3282
Job Department: 1007202 MWHC-Executive Office
Job Posted Date: Oct 08, 2021
Start the day excited to make a difference…end the day knowing you did. Come join our team.Job Summary:
This position is accountable to perform clerical and administrative support duties related to the effective operation of the department. This position must demonstrate a commitment of quality service to patients, co-workers, and physicians.
Essential Duties and Responsibilities:
- Provides and reconciles the clinical updates sent to insurance companies and governmental agencies.
- Responds to inquiries received from insurance co/governmental agencies regarding cases and determines which inquiries to obtain the Case Manager's input.
- Provides direct support for Medicare appeals per process.
- Enters authorization numbers in EPIC and closes those cases.
- Monitors data and notes trends with regards to payor responses and escalate concerns to Manager.
- Collects and checks for insurance logs daily call or fax to insurance companies as requested.
- Assesses and documents payor responses, e.g., days approved, next review date, denials, etc.
- Communicates messages retrieved via departmental phone or fax to other members of the healthcare team and follows up as needed.
- Support denials and appeals process by identifying cases in need of review, appeal or peer to peer and follow up with all parties involved.
- Other duties as assigned.
- High school graduate or equivalent.
- At least three years of recent administrative experience
- Typing speed of 50 wpm.
- Able to work in a team-oriented environment with ability to carry out assigned job duties, and exhibits flexibility in response to unexpected changes in work volume, emergency staffing and scheduling.
- Demonstrates ability to multi-task and exhibits strong time management skills.
- Proficient interpersonal, writing, and other communication skills necessary.
- Previous experience with Microsoft Office, Lotus Notes, personal computer knowledge including, but not limited to, word processing, spread sheets, electronic calendars, database management, graphics, presentations, and Internet communications.
- Bachelor’s degree
As an EOE/AA employer, the organization will not discriminate in its employment practices due to an applicant's race, color, religion, sex, sexual orientation, gender identity, national origin, and veteran or disability status.
Working at Mary Washington Healthcare
Whether you are a new grad, experienced clinical professional or wanting to begin a career in healthcare, there is no better place than Mary Washington Healthcare. As a Great Place to Work-Certified™ company we treat our Associates like family – with respect, understanding, and communication.
Safety is our top priority
As a healthcare system, patient and Associate safety is our priority which is why all Associates will be required to take the following vaccines*:
- Annual flu vaccine
- COVID-19 vaccine