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Utilization review specialist
Virgin Pulse Covington, LA
$76k-95k (estimate)
Full Time | Business Services 2 Weeks Ago
Save

Virgin Pulse is Hiring an Utilization review specialist Near Covington, LA

Utilization Review Intake Specialist

HealthComp

Covington, LA

Now is the time to join us!

At Personify Health, we believe in offering total rewards, flexible opportunities, and a diverse inclusive community, where every voice matters.

Together, we’re shaping a healthier, more engaged future.

In this role you will wear many hats, but your knowledge will be essential in the following :

Answer and route all incoming phone calls

Provide accurate information to internal and external customers regarding pre-certification process, including gathering demographic, non-clinical, and / or provider data for pre-certification via phone, fax, inter / intranet, Eldorado / Case Pac computer programs

Review service requests and manage the requests as efficiently as possible involving the appropriate department as needed

Perform data entry and maintain complete documentation of case information; assist in document maintenance or revisions;

compile monthly reports; maintain logs and files

Be able to meet productivity, quality and turnaround time requirements on a daily, weekly and monthly basis

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

What you bring to the Personify Health team :

In order to represent the best of what we have to offer you come to us with a multitude of positive attributes including :

  • Prior experience in customer service and / or medical background
  • Prior insurance and / or claims background
  • Prior experience in a medical front office or hospital patient intake, medical claims processing, or an equivalent combination of education and experience
  • Associate degree preferred in business, management, or related field

You also take pride in offering the following Core Skills, Competencies, and Characteristics :

  • Ability to safely and successfully perform the essential job functions with or without a reasonable accommodation, including meeting qualitative and / or quantitative productivity standards.
  • Ability to maintain regular, punctual attendance.
  • Ability to sit for 6-8 hours.
  • Constant use of computer keyboard and mouse; repetitive use of both hands.
  • Occasional to frequent twisting of neck; frequent bending of neck and at waist.

No candidate will meet every single desired qualification. If your experience looks a little different from what we’ve identified and you think you can bring value to the role, we’d love to learn more about you!

Personify Health is an equal opportunity organization and is committed to diversity, inclusion, equity, and social justice.

LI-REMOTE

Last updated : 2024-05-13

Job Summary

JOB TYPE

Full Time

INDUSTRY

Business Services

SALARY

$76k-95k (estimate)

POST DATE

05/03/2024

EXPIRATION DATE

06/21/2024

WEBSITE

virginpulse.com

HEADQUARTERS

PROVIDENCE, RI

SIZE

500 - 1,000

FOUNDED

2004

TYPE

Private

CEO

DAVID OSBORNE

REVENUE

$50M - $200M

INDUSTRY

Business Services

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About Virgin Pulse

Virgin Pulse is a Rhode Island-based digital health management platform that offers solutions such as wellbeing, benefits lifecycle, and employee engagement for employers.

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The following is the career advancement route for Utilization review specialist positions, which can be used as a reference in future career path planning. As an Utilization review specialist, it can be promoted into senior positions as an Utilization Review Manager - Home Care that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Utilization review specialist. You can explore the career advancement for an Utilization review specialist below and select your interested title to get hiring information.

If you are interested in becoming an Utilization Review Specialist, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become an Utilization Review Specialist for your reference.

Step 1: Understand the job description and responsibilities of an Accountant.

Quotes from people on Utilization Review Specialist job description and responsibilities

Utilization Review Specialists ensure that Doctors and Nurses choose only the best treatments for them.

03/11/2022: Fort Myers, FL

Utilization review typically refers to the review of services that have already been delivered, while utilization management often refers to the review of coverage for future medical services.

02/16/2022: Louisville, KY

Assess plans for patient care and determine what treatment is appropriate and most cost-effective

02/15/2022: Augusta, GA

Analyze electronic medical records, and inform medical staff whether a medical claim is denied,

03/11/2022: Boston, MA

Prepares and submits regular reports on utilization control and on review activities.

02/26/2022: Reading, PA

Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.

Career tips from people on Utilization Review Specialist jobs

Know where to find utilization review jobs.

03/13/2022: Clarksville, TN

Create a utilization review cover letter.

02/18/2022: Reno, NV

Sign up for free credit monitoring.

03/16/2022: New London, CT

Set up documentation shortcuts.

03/05/2022: Lawton, OK

Take the certification examination.

05/08/2022: New Bedford, MA

Step 3: View the best colleges and universities for Utilization Review Specialist.

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