Utilization Management Assistant

Cottingham & Butler; Dubuque (IA); Hybrid; USD 45,000 - 55,000; Full time

Benefits offered by this job

Flex Spending or HSA

401(k) with company match

Profit-Sharing/Defined Contribution

PTO/Paid Holidays

Company-paid ST and LT Disability

Maternity Leave/Parental Leave

Job summary

Cottingham & Butler is seeking a Utilization Management Assistant to work onsite in Dubuque, IA, or remotely. You will handle first level calls in Utilization Review for our Health & Wellness participants.

Your responsibilities include evaluating certification requests and reviewing medical records to ensure patients receive appropriate care. A CNA, LPN, or Medical Assistant is preferred with at least 1 year of relevant experience.

Benefits include a 401(k) with company match, profit-sharing, PTO, and company-paid disability.

Qualifications

• CNA, LPN, or Medical Assistant preferred.
• Background in patient health support or care.
• 1+ years of experience within this field.

Responsibilities

• Evaluate certification requests from health participants.
• Review medical records and coordinate with healthcare providers.
• Ensure patients receive appropriate care as per guidelines.

Skills

Communication

Customer Service

Detail Oriented

Education

CNA, LPN, or Medical Assistant preferred

Background in patient health support or care

1+ years of experience within this field

Job description

Overview

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

Responsibilities

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. You 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