Utilization Management Analyst - Chicago, United States - Sinai Chicago
Description
GENERAL SUMMARY/BASIC PURPOSE OF JOB:
This position provides monitoring of inpatient and outpatient accounts to ensure accuracy of submissions and proper authorizations are obtained in order to secure reimbursement.
The role includes, but is not limited to, clinical submission to the payers, securing an authorization for the visit type, continuous follow-up with payers for authorizations and/or additional information, and basic reporting for payer specific behaviors.
This also requires monitoring of payer trends and the user of Microsoft's office to track and report data for Senior Management.
MINIMUM EDUCATION:
- High School Diploma
- Preferred Associates Degree in health care or related field, Business Administration, Health Information Management.
MINIMUM WORK EXPERIENCE:
- A minimum of 4 years prior working experience with insurance payers, case management, insurance verification or appeals. This includes but is not limited to experience working with Physician Advisors, CMOs, and Social Work.
KNOWLEDGE, SKILLS AND ABILITIES:
- Excellent verbal and written communication skills.
- Must be able to interact with a diverse client base including patients and their family members; medical center staff; and external parties as required.
- High level of organizational and attention to detail skills.
- The ability to followthrough and ensure tasks are brought to successful completion.
REQUIRED LICENSES, CERTIFICATES, REGISTRATIONS:
- None
Location:
SHS - SHS SHS PT ACCES FL POOL
Schedule:
Full Time, Days, varies
More jobs from Sinai Chicago
-
rn case manager
Chicago, IL , USA, United States - 4 weeks ago
-
Shs Mgr, Care Transform Operations
Chicago, United States - 2 weeks ago
-
Cen. Schedualer
Chicago, United States - 3 weeks ago
-
patient access specialist
Chicago, United States - 3 weeks ago
-
Interpreter - Antillas Clinic Dari/pashto Language
Chicago, United States - 1 week ago
-
clinical data analyst
Chicago, United States - 4 weeks ago