Utilization Mgmt Spec
Company: Beaumont Hospital, Royal Oak (Mich.)
Location: Royal Oak
Posted on: November 21, 2022
Under general direction, assists in the provision of the highest
service level possible to patients/customers to ensure their
satisfaction. Participates in activities with third party payors in
order to maximize reimbursement.
1. Understands and accesses insurance websites. Completes required
duties as defined for specific payers to obtain authorization
numbers for payment.
2. Provides clerical support for Utilization Management; sorting
faxes and mail, obtaining authorization numbers, completing
follow-up on outstanding cases, and delivery of letters associated
with outpatient or inpatient status.
3. Utilizes electronic medical record work queues that support
Utilization Management functions.
4. Answers incoming calls or places outbound calls with appropriate
communication skills. Triages all calls to the appropriate person
for resolution and action or completes appropriate follow-up.
5. Problem solves issues that are received via phone, fax or
6. Other duties as assigned.
This document represents the major duties, responsibilities, and
authorities of this job, and is not intended to be a complete list
of all tasks and functions. It should be understood, therefore,
that incumbents may be asked to perform job-related duties beyond
those explicitly described.
To perform this job successfully, an individual must be able to
perform each essential duty satisfactorily. The requirements listed
below are representative of the knowledge, skill and/or ability
required. Reasonable accommodations may be made to enable
individuals with disabilities to perform the essential duties.
A. Education / Training:
High School Diploma or G.E.D. completion required. Post high school
training and/or academic coursework leading toward associate's or
bachelor's degree preferred.
B. Work Experience:
Two years of healthcare experience preferred.
C. Certification, Licensure, Registration:
D. Other Qualifications:
Competency and comprehension of basic medical terminology.
Well-developed computer skills and/or business related
Keywords: Beaumont Hospital, Royal Oak (Mich.), Royal Oak , Utilization Mgmt Spec, Other , Royal Oak, Michigan
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