14340501
Located in Amarillo, TX
Pay: $15-17/hr.
Job Full Description
Utilization Review Support Technician I-II
Position Purpose: To provide administrative support to the Utilization Review nurse/Managed Care Nurse and Director as well as maintaining files, data, and reporting mechanisms of the department.
Primary Functions:
- Responsible for compiling Precertification/UR Intake forms for the UR Specialist/Managed Care Nurse according to procedures, gathering faxed clinical, and forwarding to the UR Specialist/Managed Care Nurse
- Responsible for answering MC phones and logging calls in GBAS according to policy; and referring calls to customer service, or Pre-Determinations as needed.
- Responsible for attending renewal meetings, and maintain the Group Grid, and distributing monthly
- Responsible for timely input of Pre-Determination requests, approval, and denials, and communicating with Providers.
- Responsible for tracking Denials and appeals for Annual Denial reporting
- Responsible for providing direct technical support to the UR Specialist.
- Assisting with scanning, and retrieving UM documents; and creating and tracking certified mail items.
- Responsible for daily generation of Precertification letters, and maintaining the UR Desktop accurately
- Responsible for UM File completion and readying files for digital scanning
- Completes other duties as assigned by the manager/supervisor within the scope and education of the individual
Has the ability to:
- Get along with others
- Function as a team player
- Accept constructive criticism from the supervisor or manager
- Follows work rules and company policies
Requirements:
- High school diploma or equivalent
- Minimum of 2 years of experience in a clerical, secretarial, or administrative assistant role
- Proficient written and verbal communication skills
- Strong organizational, time management, and decision-making abilities
- Prior experience with ICD-10 and CPT coding
- Ability to work effectively with minimal supervision
- Advanced computer skills, including proficiency in Microsoft Word, Excel, and database management
Amarillo, TX
1982
6605 I-40 West
Amarillo, TX 79106
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