Utilization Management Specialist

Company: VirtualVocations
Location: Macon
Posted on: November 8, 2024

Job Description:

A company is looking for a Utilization Management Specialist responsible for obtaining timely authorizations from health plans and acting as a liaison between insurance companies and internal teams.

Key Responsibilities

Develop relationships with insurance companies to submit and track prior authorizations and concurrent reviews
Synthesize clinical data into authorization requests and assist with appealing denials
Collaborate with Finance, Revenue Cycle, Admissions, and Clinical departments

Qualifications

3+ years of healthcare experience in utilization management, billing, insurance verification, or direct patient care
Knowledge and experience with EMR systems
Familiarity with HIPAA privacy requirements for patient information
Strong organizational and time management skills
A passion for the mission and values of the organization

Keywords: VirtualVocations, East Point , Utilization Management Specialist, Executive , Macon, Georgia

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