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HealthCheck360

Utilization Management Assistant

Clinical Support & Patient AdministrationConfirmed live in the last 24 hours
Full-timeDubuque, IA, USANo salary listed

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

  • Answer first level calls in Utilization Review for HealthCheck360 participants
  • Evaluate certification requests by reviewing the group specific requirements
  • Triage the call to determine if a Utilization Review Nurse is needed to complete the call
  • Review medical records
  • Coordinate with healthcare providers
  • Ensure that patients receive appropriate, cost-effective care in accordance with clinical guidelines and insurance requirements

Desired Qualifications

  • Communication - Strong interpersonal skills to connect with patients, doctors, internal team members, and providers
  • Customer Service - Friendly demeanor and understanding to relay sensitive information to members
  • Detail Oriented - Accuracy and attention to detail when reviewing pre-certifications and plans

About the Company

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Total funding
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