Utilization Mgmt Rep- Per Diem - Oak Brook
4 weeks ago

Job summary
Manage incoming fax phone and portal communications or any other requests from internal and external customers pertaining to clinical requests approvals authorizations and denials determine action required and document all activities performed accurately and clearly in the designated database/area(s) of EHR.
- Communicate clinical needs authorizations and denials to the Utilization Review Nurses and Managers for follow up
- Verify insurance information provided by callers fax or Portal and send information to payers as requested including discharge dates disposition or clinical reviews/summaries prepared by UM RNs if directed to do while ensuring that all actions taken align/comply with the confidentiality HIPAA compliance guidelines
Job description
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