Role and Responsibilities Patient Service Rep for case management/ Utilization Review Management . understands authorizations, denials, insurance, and would support the UR nurses.
· Assists with answering telephone, scheduling appointments, confirming appointments and answering questions.
· Answer phones and greet incoming patients and visitors.
· Provides support to ensure that all utilization management documentation and information requirements are met.
· Composes list of resources for Case Managers and Social Workers as needed.
· Congers with assigned nurse regarding need for any additional hospital services or referrals and assist with referral process, if needed.
· Coordinates department statistics and forwards information to budget department and director.
· Oversees insurance authorizations, reviews, and denials.
· Coordinate with office staff for timely care of patients
· Enters documentation integrity information in the computer and keeps a log.
· Participate in various projects and/or meetings, and complete other tasks as assigned by management
· Covers Department Secretary responsibilities on an as needed basis.
Additional Requirements:
· 2 Years Experience in Case Management
· Must have High School Diploma/GED
Job Type: Full-time
Pay: $22.50 - $23.00 per hour
Benefits:
- Dental insurance
- Health insurance
- Vision insurance
Schedule:
- Monday to Friday
- Weekends as needed
Work setting:
Education:
- High school or equivalent (Preferred)
Experience:
- Utilization review: 2 years (Preferred)
- Case management: 2 years (Preferred)
Work Location: In person