TEAM ASSISTANT - Utilization Management

Inpatient Utilization Management Coordinator

Assist Inpatient Utilization Management RNs and Unit Assistant by completing data entry and collaborating with insurance companies. Responsibilities include running discharge reports and notifying insurance companies of discharges. Emailing denial letters to physicians, maintaining a denial spreadsheet, following up on P2Ps, and documenting outcomes and notifications in the denial tab. Ability to multitask phone calls, emails, and faxes. Scheduling and obtaining prior authorization for outpatient testing, labs, infusion, etc. Obtaining prior authorization for post-acute services. Ability to interact with patients, employees, and other occupants in an appropriate manner. Moon forms/CC44 compliance. Provide moon forms for surgeries, direct admits, status changes, and transfers. Provide a copy to the patient, original copy placed in chart, and document completion of the moon form/CC44 in Cerner. Occasional mailing of moon form via certified mail. Utilizing payer websites for approvals, prior authorization, and denials. Keep up to date on payer policies. Covering Unit Assistant PTO. Assist Unit Assistant with faxes, approvals, and Kronos as needed. Ability to receive, understand, and implement direction from supervision and management. Ability to effectively function within the framework of department and organizational policies and procedures. Other duties as assigned by the Director or designee.

Education/Experience Requirements:

• High School Diploma or equivalent
• Proficiency with Microsoft Office Suite (Outlook, Word, Excel, PowerPoint)
• Basic data entry and data management skills with strong attention to detail
• Comfortable using email, calendars, virtual meeting tools, and internal communication platforms
• Ability to navigate and learn new software systems quickly; almost all duties of this position are electronic in nature

Job Location: Aultman Hospital Main Campus