HybridRemote options available; onsite in Dubuque, IA.
Medical, Clinical & Veterinary
About the job
Requirements
CNA, LPN, or Medical Assistant preferred
Background in patient health support or care
1+ years of experience within this field
Responsibilities
The Utilization Management Assistant answers first level calls in Utilization Review for HealthCheck360 participants.
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call.
You will be responsible for reviewing medical records, coordinating with healthcare providers, and ensuring that patients receive appropriate, cost-effective care in accordance with clinical guidelines and insurance requirements.
Desired Qualifications
Communication - Strong interpersonal skills to be able to connect with patients, doctors, internal team members, and providers
Customer Service - Friendly demeanor and understanding to be able to relay sensitive information to members
Detail Oriented - Accuracy and attention to detail when reviewing pre-certifications and plans
Utilization Management Assistant
Location: Onsite in Dubuque, IA. Also accepting remote applicants.
Are you passionate about patient care and thrive in a fast-paced, professional environment? We are seeking a dedicated Utilization Management Assistant to join our healthcare team. We are looking for individuals with experience in a medical setting, including but not limited to a receptionist, scheduler, insurance verification, LPN, CNA, Medical Assistants, or individuals with a background in customer service who are looking to make a meaningful impact behind the scenes. If you are looking to get into a professional office setting with daytime office hours and weekends/holidays off, this is the role for you!
The Utilization Management Assistant answers first level calls in Utilization Review for HealthCheck360 participants. They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You will be responsible for reviewing medical records, coordinating with healthcare providers, and ensuring that patients receive appropriate, cost-effective care in accordance with clinical guidelines and insurance requirements.
Preferred Skills
Communication - Strong interpersonal skills to be able to connect with patients, doctors, internal team members, and providers
Customer Service - Friendly demeanor and understanding to be able to relay sensitive information to members
Detail Oriented - Accuracy and attention to detail when reviewing pre-certifications and plans
HealthCheck 360 was created with the employer's needs and the participant's experience in mind. We focus on reducing medical costs, while increasing employee engagement and productivity. This is accomplished by providing onsite biometric screenings, engaging participants through technology and programming, educating the participant with risk-specific targeted communications, and supporting positive behavior change through our Health Coaching and Condition Management programs.