Utilization Review Specialist ARRMC (Utilization Review)

Utilization Review Specialist ARRMC (Utilization Review)

Additional Position Details: FTE: 1.000000 | Full Time | Primarily Mon - Fri / 8AM - 5PM

Starting Wage: $21.86-$30.07 per hour, depending on experience

Please note: This is a remote position. Candidates will be required to have reliable broadband internet and personal cell phone service. Remote work may include training and working during Pacific Standard business hours. Also, our remote work opportunities are limited to specific states, and remote work may not be supported in the state in which you reside.

Job Summary

The Utilization Review (UR) Specialist is responsible for ensuring the timely and accurate submission of initial authorization requests, periodic clinical updates, and handling payer communications. This role plays a critical part in facilitating appropriate care authorization by coordinating with payers, scheduling peer-to-peer (P2P) reviews, and managing utilization review (UR) processes to support optimal reimbursement and compliance with payer requirements.

Position Qualifications

Education

• High School Diploma, GED or equivalent experience demonstrating the ability to effectively communicate as required for the position, is required
• Associate degree in business, healthcare administration or related field, is preferred.

Experience

• 3 years of experience in administrative functions in care coordination and/or utilization management in healthcare settings, is required
• Experience with Microsoft Word and Excel, is required
• Experience with EPIC highly desired.
• Current understanding of CMS regulations related to hospital discharge requirements is preferred

Total Rewards Package

• Earn a competitive and progressive salary.
• Benefit from health plans that focus on health and wellness, including medical, dental, vision, and wellness beginning within 30 days of hire.
• Plan for your future with a retirement package that includes up to 6% employer contribution.
• Experience a healthy work-life balance with our generous earned time off (ETO).
• Continue to enhance your education through our tuition reimbursement and tuition repayment plans.

Explore Asante more by visitingwww.asante.org/careers

At Asante we believe that we are defined by our values - the traits that guide us as we serve patients and the community:

Excellence - Respect - Honesty - Service - Teamwork

Asante is an equal opportunity employer. We are committed to employ and advance in employment women, minorities, qualified individuals with disabilities and protected veterans.