What are the responsibilities and job description for the UM PRIOR AUTH SPECIALIST position at Southwest General Health Center?
Summary
Medical Terminology, prefer
Prefer experience with ICD 10
- POSITION INFORMATION
- Position summary:
- Integral member of the Utilization Management (UM) team. Supports UM processes through accurate and timely notification of admission and communication of clinical review information to insurance companies. Strong, clear, and effective communication, excellent customer service, organization, time management, and computer skills are imperative in this role. Collaborates and coordinates with members of the UM and Revenue Cycle teams to ensure timely and efficient delivery of required workflow, services and tasks to result in:
- Support of positive patient health care outcomes
- Increased patient/health care team outcomes and satisfaction
- Improved communication, awareness, and adherence to regulatory requirements associated with utilization
- Support for appropriate level of care and decreased inpatient bed day denials
- Appropriate and timely authorization for level of care
- Decreased denials
- Appropriate reimbursement
- MINIMUM QUALIFICATIONS
- Education:
- High School Graduate or Equivalent.
- Required length and type of experience:
- At least two (2) years of administrative/office/clinical support/managed care or utilization management, healthcare experience.
Medical Terminology, prefer
Prefer experience with ICD 10
- Required licensure, certification or registry:
- None
