Bonney Staffing
Location: Portland,ME, USA
Date: 2025-01-10T08:18:30Z
Job Description:
Compensation: $21.53 - $27.86 per hourThe Temporary Utilization Review Assistant you will be responsible for providing non-clinical support to the Utilization Management (UM) team. This is a temporary opportunity with the potential for up to a 6-month assignment, based onsite in Portland, Maine.Details:Schedule: Monday - Friday, 8:00 AM - 4:30 PMPay: $21.53 - $27.86/Hr.Start Date: ASAP, Potential up to 6 monthsDuties & Responsibilities:Support UM nurses, receive authorization requests, and answer general authorization questions from members and providers.Manage multiple authorization queues by reviewing, screening, entering, and processing authorization requests from members and providers, in compliance with HMD guidelines, regulatory standards, and contractual obligations.Upload faxes to the medical management system.Produce notifications by letter to members and providers as required by regulation and accreditation standards.Manage the notification queue and send daily census information to targeted facilities as needed.Participate in and contribute to Health Management Department meetings and process improvement initiatives.Ensure compliance with contractual requirements and organizational/departmental standards regarding authorizations, clinical reviews, and provider/member communications.May be cross-trained as a backup for other non-clinical areas of HMD.Qualifications:Education: Associate's Degree or equivalent education and experience.Experience: 2 years of managed care experience, including call center experience. Experience with CPT, ICD-10, and HCPCS coding is a plus.Required Certifications: Medical Assistant Certification is a plus.Required Skills & Knowledge:Basic knowledge of medical terminology, current healthcare benefits, and managed care insurance plans.Basic knowledge of Microsoft Word and Excel.Familiarity with CMS and NCQA regulations is a plus.Strong technical skills in office systems, electronic health records, and databases.Strong organizational skills with the ability to prioritize and multi-task in a fast-paced, high-pressure environment.Ability to take direction from multiple individuals and prioritize tasks appropriately to meet deadlines.Ability to handle confidential and sensitive information in a discreet and professional manner.Strong communication skills with both internal and external customers.Ability to work independently while also collaborating with other internal departments.Critical thinking skills: Ability to identify root causes and suggest creative solutions.Initiative: Ability to take initiative while seeking input/advice when necessary.If you believe you are a qualified candidate, please apply or contact us today!#BSCP
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