Utilization Management Specialist
C
Corewell Health
📍 Southfield, MI, United States
Job Description
Job Summary
Under general direction, assists in the provision of the highest service level possible to patients/customers to ensure their satisfaction. Participates in activities with third party payors in order to maximize reimbursement.
Essential Functions
+ Understands and accesses insurance websites. Completes required duties as defined for specific payers to obtain authorization numbers for payment.
+ Provides clerical support for Utilization Management; sorting faxes and mail, obtaining authorization numbers, completing follow-up on outstanding cases, and delivery of letters associated with outpatient or inpatient status.
+ Utilizes electronic medical record work queues that support Utilization Management functions.
+ Answers incoming calls or places outbound calls with appropriate communication skills. Triages all calls to the appropriate person for resolution and action or completes appropriate follow-up.
+ Problem ...
Under general direction, assists in the provision of the highest service level possible to patients/customers to ensure their satisfaction. Participates in activities with third party payors in order to maximize reimbursement.
Essential Functions
+ Understands and accesses insurance websites. Completes required duties as defined for specific payers to obtain authorization numbers for payment.
+ Provides clerical support for Utilization Management; sorting faxes and mail, obtaining authorization numbers, completing follow-up on outstanding cases, and delivery of letters associated with outpatient or inpatient status.
+ Utilizes electronic medical record work queues that support Utilization Management functions.
+ Answers incoming calls or places outbound calls with appropriate communication skills. Triages all calls to the appropriate person for resolution and action or completes appropriate follow-up.
+ Problem ...