Utilization Management Assistant

Cottingham & Butler; Des Moines (IA); Hybrid; USD 42,000 - 54,000; Full time

Benefits offered by this job

401(k) with company match

Profit-sharing/Defined contribution

PTO/Paid Holidays

Company-paid STD/LTD Disability

Maternity Leave/Parental Leave

Job summary

Cottingham & Butler is seeking an Utilization Management Assistant to join our healthcare team in Dubuque, IA. You will handle first level Utilization Review calls, review medical records, and coordinate with providers to ensure cost-effective, guideline-conformant patient care.

We prefer candidates with CNA/LPN/Medical Assistant background or related patient health support experience and at least 1 year in the field.

Qualifications

• Experience in a medical setting, including receptionist, scheduler, insurance verification, LPN, CNA, Medical Assistant, or customer service backgrounds.
• Daytime office hours with weekends/holidays off.
• Onsite in Dubuque, IA with acceptance of remote applicants.

Responsibilities

• Answer first level calls in Utilization Review for Health & Wellness participants.
• Evaluate certification requests by reviewing group-specific requirements.
• Triage calls to determine if a Utilization Review Nurse is needed.
• Review medical records and coordinate with healthcare providers.
• Ensure patients receive appropriate, cost-effective care per guidelines and insurance requirements.

Skills

Communication

Customer Service

Detail Oriented

Education

CNA, LPN, or Medical Assistant preferred

Job description

Location: Onsite in Dubuque, IA. Also accepting remote applicants.

Are you passionate about patient care and thrive in a fast-paced, professional environment? We are seeking a dedicated Utilization Management Assistant to join our healthcare team. We are looking for individuals with experience in a medical setting, including but not limited to a receptionist, scheduler, insurance verification, LPN, CNA, Medical Assistants, or individuals with a background in customer service who are looking to make a meaningful impact behind the scenes. If you are looking to get into a professional office setting with daytime office hours and weekends/holidays off, this is the role for you!

The Utilization Management Assistant answers first level calls in Utilization Review for our Health & Wellness participants. They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. Y ou will be responsible for reviewing medical records, coordinating with healthcare providers, and ensuring that patients receive appropriate, cost-effective care in accordance with clinical guidelines and insurance requirements.

Preferred Skills

• Communication - Strong interpersonal skills to be able to connect with patients, doctors, internal team members, and providers
• Customer Service - Friendly demeanor and understanding to be able to relay sensitive information to members
• Detail Oriented - Accuracy and attention to detail when reviewing pre-certifications and plans

Qualifications:

• CNA, LPN, or Medical Assistant preferred
• Background in patient health support or care
• 1+ years of experience within this field
• Flex Spending or HSA
• 401(k) with company match
• Profit-Sharing/Defined Contribution (1-year waiting period)
• PTO/Paid Holidays
• Company-paid ST and LT Disability
• Maternity Leave/Parental Leave

About Cottingham & Butler:

At Cottingham & Butler, we sell a promise to help our clients through life's toughest moments. To deliver on that promise, we aim to hire, train, and grow the best professionals in the industry. We look for people with an insatiable desire to succeed, are committed to growing, and thrive on challenges. Our culture is guided by the theme of "better every day" constantly pushing ourselves to be better than yesterday - that is who we are and what we believe in.

As an organization, we are tremendously optimistic about the future and have incredibly high expectations for our people and our performance. Our ability to grow as a company, fuels investments in new resources to better serve our clients and provide the amazing career opportunities our employees want and deserve. This is why we are a growth company and why we are committed to being better every day.

Interested in building your career at Cottingham & Butler? Get future opportunities sent straight to your email.