What are the responsibilities and job description for the Utilization Management Technician position at GTT, LLC?
Job Title: Utilization Management Technician
Location: Everett, WA 98201
Work Setting: Hybrid (Remote On-site)
On-site Requirement: 2 days/week at Everett Pacific Campus
Schedule: Monday – Friday (5x8s)
Shift Timing: Start between 7:00 AM – 8:00 AM
Position Overview
The Utilization Management Technician (Utilization Management Assistant) is responsible for supporting utilization management operations, ensuring compliance with healthcare regulations, and maintaining accurate data reporting. This role involves working closely with payer systems, provider portals, and internal platforms to manage authorizations, denials, and clinical documentation.
Key Responsibilities
- Update and manage payer authorizations
- Review and work on claim denials
- Monitor incoming faxes and accurately input data into Epic and Genesis systems
- Work within provider portals such as Availity
- Submit clinical documentation to payers in a timely manner
- Maintain utilization management (UM) data for compliance and reporting
- Generate and process daily, weekly, and monthly UM reports
- Maintain organized electronic and paper filing systems
- Support Health Plan audits, including:
- Data collection and documentation
- Preparation for NCQA, DMHC, and CMS audits
- Assist in compliance tracking and reporting timelines
- Utilize referral, bed days, and claims databases for reporting and analysis
- Communicate effectively with internal teams and external stakeholders
- Answer and screen incoming calls as needed
- Perform additional duties assigned by the UM Compliance Manager or leadership
Required Skills & Qualifications
- Associate’s Degree (Required)
- Strong experience with Microsoft Office Suite (Word, Excel, Teams, PowerPoint, Access)
- Hands-on experience with Epic (Required)
- Familiarity with provider portals such as Availity
- Knowledge of managed healthcare systems and payer processes
- Understanding of healthcare regulations:
- CMS
- NCQA
- DMHC
- ADA
- HIPAA
- Strong analytical and data management skills
- Ability to work independently in a remote/hybrid environment
- Excellent communication and collaboration skills
- High level of integrity, especially when handling patient financial information
Pay: $25.00 - $26.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Vision insurance
Work Location: Hybrid remote in Everett, WA 98201
Salary : $25 - $26