UTILIZATION REVIEW ASSISTANT

UTILIZATION REVIEW ASSISTANT in Middleburg Heights, OH - Southwest General Career Site UTILIZATION REVIEW ASSISTANT in Middleburg Heights, OH - Southwest General Career Site

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UTILIZATION REVIEW ASSISTANT

• Middleburg Heights, OH
• Southwest General Health Ctr
• PATIENT REGISTRATION
• FULL-TIME , Days , 7:00 am- 3:30 pm Monday - Friday with Rotating Weekends 8:00 am - 4:30 pm
• Newly Created Position
• Req #: 173210

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Summary

• POSITION INFORMATION
• Position summary:
• An integral member of the Patient Registration team, this position supports the patient admission process by ensuring accurate and timely notification of admissions, verification of insurance coverage, and communication of clinical review information to insurance companies. The position collaborates closely with Utilization Management and Revenue Cycle teams to facilitate appropriate level-of-care determinations, timely authorizations, and efficient completion of required workflows.

Success in this role requires strong communication and customer service skills, attention to detail, organization, time management, and proficiency with computer systems. Through effective coordination and communication, this position contributes to positive patient outcomes, improved patient and health care team satisfaction, reduced denials, and appropriate and timely reimbursement.

• MINIMUM QUALIFICATIONS

• Education:

• High School Graduate or Equivalent.

• Required length and type of experience:

• At least two (2) years of administrative/office/clinical support/managed care or utilization management, healthcare experience.

• Prefer experience with managing insurance authorizations and interaction with payers. Medical Terminology, prefer.

• Prefer experience with ICD 10.

• Detail-oriented and highly organized, with strong analytical and problem-solving skills.

• Excellent customer service, communication, presentation, and relationship-building skills.

• Strong written and verbal communication skills.

• Ability to work independently and effectively as part of a team in a fast-paced environment.

• Demonstrated proficiency with personal computers, Microsoft Office applications, and general office equipment, including printers, copiers, and fax machines.

• Strong typing and data entry skills.

• Strong attention to detail and accuracy.

• Effective organizational and time management skills, with the ability to prioritize and manage multiple tasks.

• Ability to maintain current knowledge of applicable regulatory requirements, organizational policies, and internal procedures.

• Ability to handle confidential information with discretion and professionalism.

• Required licensure, certification or registry:

• None

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Southwest General Health Center

18697 Bagley Road, Bldg C

Middleburg Heights, OH 44130

440-816-8000

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