Utilization Management Assistant - Daytime Hours

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

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.