A company is looking for a Utilization Management Representative to assist in the administration of Utilization Management functions.
Key Responsibilities
- Process clinical information and manage authorizations and concurrent denials
- Communicate with insurance companies and external payor representatives to ensure proper authorization and documentation
- Perform data entry and maintain accurate records of patient information and insurance requirements
Required Qualifications
- High school diploma/GED or equivalent working knowledge
- Three years of experience in healthcare (e.g., Nursing Assistant, Medical Assistant, Patient Care Tech)
- Understanding of medical terminology
- Proficiency in organizational and time management skills
- Bilingual skills are preferred for some assignments
