Overview
Utilization Review Assistant Jobs in Newport News – Virginia – USA at Riverside Health System
Newport News, Virginia
Overview
Provides administrative support to the Utilization Management team, including delivery of multiple Medicare & other insurance required forms to patients in a timely manner. Thoroughly documents all updates on accounts in the electronic medical record, including communications with insurance companies, requests for clinical updates, denials received, and others as needed. Assists in managing all work queues assigned to Utilization Management to ensure timely follow up on accounts.
What you will do
Ensures seamlesscommunicationwith payers. Retrieves voicemails and faxes for the department and transcribes the information into the electronic medical record. Communicates in a positive, professional manner at all times.
Diligently manages all clinical review work queues assigned to Utilization Management. Follows up on accounts in a timely manner, ensuring communications with payers are documented thoroughly. Closes accounts as soon as feasible in order for Revenue Cycle to process claims. Communicates excessive delays to the Utilization Management team.
Administers all Virginia State Observation letters & Medicare Outpatient Observation Notice (MOON) to patients within one calendar day of being placed in an observation or outpatient status. Must have the ability to answer general questions about these forms and document delivery in the electronic medical record, including all exceptions. Scans copies into the electronic medical record.
Promotesteamworkby working effectively as a team member as well as independently. Communicates and collaborates with multiple team members, including Utilization Management RNs, care managers, nursing unit staff, unit secretaries, insurance representatives, and others as needed. Seeks assistance as needed. Consistently keeps team informed of changes as they arise.
Assists the Director and other members of the Utilization Management team in administrative duties, to include mailing appeal letters, scanning and uploading information into the electronic medical record, and ordering office supplies as needed. Takes minutes at team meetings.
Qualifications
Education
High School Diploma or GED, with 3 years healthcare experience (Required) or
Associates Degree, Healthcare/Business Administration or Related (Required)
Experience
2 years healthcare experience (Preferred)
To learn more about being a team member with Riverside Health System visit us at
Title: Utilization Review Assistant
Company: Riverside Health System
Location: Newport News – Virginia – USA
Category: Healthcare, Administrative/Clerical
