Utilization Review Assistant

Mosaic Life Care; Saint Joseph (MO); On-site; USD 38,000 - 47,000; Full time

Job summary

Mosaic Life Care in Saint Joseph, MO, seeks an Utilization Review Assistant to handle the administrative side of Utilization Management, supporting the medical review process and coordinating documentation.

You will work with care managers and social workers, manage communications with patients, and ensure regulatory compliance, while developing strong teamwork and communication skills. This is a full-time role requiring a high school diploma and may require travel to off-site locations.

Qualifications

• HS diploma or GED required.
• Healthcare experience preferred.

Responsibilities

• Communicate required healthcare documents to patients or representatives.
• Adhere to regulatory and compliance standards.
• Understand benefits including Medicaid and Medicare.
• Assist utilization review staff, care managers and social workers with administrative duties.
• Document data entry
• Retrieve messages by phone and voicemail
• Distribute mail within the department
• Manage worklists and priorities
• Perform additional duties as assigned

Skills

Interpersonal skills

Verbal and written communication

Team collaboration

Computer literacy

Education

High School Diploma or GED

Job description

Job Description

The Utilization Review Assistant is responsible for the administrative components of Utilization Management that primarily focuses on supporting the medical review process.

The Utilization Review Assistant is responsible for the administrative components of Utilization Management that primarily focuses on supporting the medical review process.

Responsibilities

• Responsible for communication of required healthcare documents to patients and/or representatives.
• Adhere to regulatory and compliance standards
• Understanding benefits including Medicaid and Medicare
• Work closely with utilization review staff, care managers and social workers to assist with any administrative responsibilities or needs.
• Documentation entry
• Phone and Voicemail retrieval
• Mail distribution within the department
• Worklist management
• Other duties assigned

Education

• H.S. Diploma - or GED - Required

Work Experience

• Experience in healthcare, managed care, hospital, or clinical setting, or other comparable work experience. - Preferred

Licenses and Certifications

• Upon Hire

Travel Requirements

• Travel to off-site locations may be required. - Required

Skills and Abilities

• Hand/eye coordination: speaks clearly; good hearing, ability to use computers, printers and telephone equipment
• Interpersonal skills
• Ability to work as a member of a team and develop trusting relationships quickly
• Excellent verbal and written communication skills including sensitivity to other cultures and ethnicities.

Essential Technical/Motor Skills

• Essential Technical/Motor Skills

Essential Mental Abilities

• Implements and provides ongoing support of members care plan, recognizes alternatives, identifying problems.
• Provides patient and family teaching about health related needs, financial needs and other coping issues.
• Concentrates on plans and roles of other team members, understanding all responsibilities and plans.

Essential Sensory Requirements

• Visual and hearing skills to obtain a driver’s license are required.
• Ability to communicate with members and families, communicating in person and on phone.

Exposure to Hazards

• Exposure to Hazards

Other Skills And Abilities

• Must have access to transportation