[Hiring] Utilization Management Assistant @Geisinger

Role Description

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.

• 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.

Qualifications

• High School Diploma / GED
• Minimum of 3 years of Healthcare experience

Requirements

• High School Diploma or Equivalent (GED) - Required
• Minimum of 3 years - Healthcare (Required)

Benefits

• Full benefits (health, dental and vision) starting on day one
• Three medical plan choices, including an expanded network for out-of-area employees and dependents
• Pre-tax savings plans with healthcare and dependent care flexible spending accounts (FSA) and a health savings account (HSA) with employer contribution
• Company-paid life insurance, short-term disability, and long-term disability coverage
• 401(k) plan that includes automatic Geisinger contributions
• Generous paid time off (PTO) plan that allows you to accrue time quickly
• Up to $5,000 in tuition reimbursement per calendar year
• MyHealth Rewards wellness program to improve your health while earning a financial incentive
• Family-friendly support including adoption and fertility assistance, parental leave pay, military leave pay and a free Care.com membership with discounted backup care for your loved ones
• Employee Assistance Program (EAP): Referrals for childcare, eldercare, & pet care; Access free legal guidance, mental health visits, work-life support, digital self-help tools and more
• Voluntary benefits including accident, critical illness, hospital indemnity insurance, identity theft protection, universal life and pet and legal insurance