Authorization Support: Assist in obtaining authorization and continued stay authorizations from insurance companies. 

Data Management: Track and distribute fax communication and upload documents from insurance portals into HER. 

Communication: Serve as a liaison between providers, patients, payers and internal departments to facilitate utilization management services. 

Documentation: Maintain accurate records of authorization, denials, appeals, and other UM activities as needed. 

Policy Adherence: Follow UM policies and procedures, escalating issues when necessary. 

Customer Service: Complete administrative duties which may include fax distribution, answer telephone inquiries and forwarding to the appropriate team members. 

Required Education: High School Diploma or equivalent 

Preferred Education: Some college level education 

Licensing/ Certification

 Licensure/Certification Required: N/A 

Licensure/Certification Preferred: N/A  

Minimum Qualifications 

 Years and Type of Required Experience: One (1) year  of experience in an acute care academic medical center or comparable organization  

Other Knowledge, Skills and Abilities Required: Knowledge of computers and various computer programs such as Microsoft Suite products [Word, Excel, and Adobe Professional] 

Other Knowledge, Skills and Abilities Preferred: Effective communication skills, both verbal and written . Strong organization skills, follow-through abilities and time management skills . Solid problem solving and decision-making skills . Demonstrated flexibility and assertiveness. Skills in establishing and maintaining cooperative and “team” oriented working relationships with others.  

Working Conditions: Periods of high stress and fluctuating workloads may occur.  May have periods of constant interruptions.  Prolonged periods of working alone.  

Physical Requirements 

Physical Demands: N/A 

Work Position: Sitting