Utilization Review Admissions Specialist - Medusind
Prescott, AZ 86301
About the Job
At Medusind we take immense pride in offering superior, cost-effective solutions covering the whole spectrum of tasks and processes to the healthcare industry. A significant factor is that our workforce comes with rich domain expertise and robust compliance norms.
Our four-prong approach of an excellent management team coupled with a detailed eye for processes experienced manpower, and cutting-edge technology helps us deliver superior, cost-effective services to our clients across the globe.
The Utilization Review Admissions Specialist is to obtain initial insurance authorizations for patient care and treatment. This individual will be assigned cases each day and be expected to work faxable items on the weekend for the insurance companies that are not open for live authorizations.
Position Details: Fulltime, Remote, $20.00/Hourly.
Responsibilities
- Perform utilization review functions including obtaining pre-authorization and obtaining patient clinical updates
- Maintain accurate and timely documentation.
- Develop collaborative partnership relationships with insurance care managers in order to provide clients with expeditious delivery of service.
- Develop collaborative partnership relationships with health care providers and support staff through frequent communication and interaction.
- Function as a member of the Utilization Review Team to ensure that all daily responsibilities are met.
- Respond to insurance denials through the appeals process when appropriate.
- File retrospective reviews as needed.
- Participate in continuing professional education.
- These duties and responsibilities are not the full scope of the job description and are subject to change upon company and client demand. Additional tasks may be assigned from time to time dependent on current or projected business needs.
Qualifications
- Knowledge of medical and behavioral health terminology, physiology, concepts of disease and treatment methodologies.
- Knowledge in reviewing medical and behavioral health records for medical necessity.
- Skill in operating a personal computer utilizing a variety of software applications a must.
- Organized and able to meet deadlines consistently.
- Excellent customer service skills.
- Experience in Substance abuse/ Mental Health fields is preferred.
About Medusind:
Since 2002, organizations across the entire healthcare spectrum have leveraged our deep expertise and high-quality solutions to maximize revenue, reduce operating costs and navigate the changing healthcare landscape.Medusind’s unique combination of deep industry expertise, robust operational capability, and client-focused service significantly improves the efficiency and profitability of healthcare organizations. Client satisfaction is the primary focus of the Medusind leadership and staff.Our highly experienced personnel, cutting edge technology, and forward thinking approach allows us to deliver effective solutions while staying ahead of healthcare industry changes.
Source : Medusind