Utilization Management Technician

Utilization Management Technician Opportunity!!

This Jobot Consulting Job is hosted by : Robert Reyes

Are you a fit? Easy Apply now by clicking the "Apply Now" button and sending us your resume.

Salary : $21 - $25 per hour

A bit about us :

Prestige Hospital System

Exceptional Health Care

#1 in both California and Los Angeles

• in a broad assessment of excellence in hospital-based patient care.

“Best Hospitals” National Honor Roll 35 consecutive years

Mission and Vision

Our mission is to deliver leading-edge patient care, research, education and community engagement.

Our vision is to heal humankind, one patient at a time, by improving health, alleviating suffering and delivering acts of kindness.

Why join us?

Competitive Salary$$

Variety of benefits and perks designed to support your well-being and professional growth. Here are some of the key benefits :

Health and Medical Benefits : Comprehensive health plan options, including medical, dental, and vision coverage, as well as flexible spending accounts to offset medical costs.

Retirement Benefits : Retirement plans to help you secure your financial future.

Tuition Benefits : Free tuition for yourself or an immediate family member after two years of employment.

Time Off : Paid and unpaid time off for vacation, personal health, and family care.

Well-being Programs : Resources to support your physical, mental, and spiritual health.

Employee Discounts : Discounts on sports tickets, gym memberships, event tickets, and more.

Professional Development : Opportunities for growth and development through various training programs and resources.

If you are passionate, thrive in a fast-paced environment and are ready to take your career to the next level, we would love to hear from you.

Job Details

Job Details :

We are seeking a seasoned consulting utilization management technician to join our dynamic healthcare team. The successful candidate will be responsible for managing urgent, routine, pre-service, and retro authorization requests, processing prior authorization requests with precision and promptness. This role involves using various business applications to perform analysis, gather information, and enter prior authorization data necessary for claims adjudication. The candidate will use their critical thinking skills to identify missing information and make prior authorization processing determinations based on clinical protocols and other guidelines. You will also interact with internal and external customers to provide and obtain information and ensure the delivery of outstanding service and quality.

Responsibilities :

1. Manage urgent, routine, pre-service, and retro authorization requests with accuracy and timeliness.

2. Use various business applications to perform analysis, gather information, and enter prior authorization data necessary for claims adjudication.

3. Use critical thinking skills to identify missing information and make prior authorization processing determinations based on clinical protocols and other guidelines.

4. Interact with internal and external customers to provide and obtain information and ensure the delivery of outstanding service and quality.

5. Collaborate with a team of healthcare professionals to deliver effective patient care.

6. Ensure compliance with all federal and state laws and regulations related to utilization management.

7. Keep up-to-date with the latest trends and advancements in the healthcare industry.

Qualifications :

1. A minimum of 5 years of experience in a similar role within the healthcare industry.

2. Proficiency in EPIC and retro authorization is mandatory.

3. Bachelor’s degree in a healthcare-related field. A master’s degree will be an added advantage.

4. Strong understanding of medical terminology, coding, and billing.

5. Excellent critical thinking skills and the ability to make sound decisions based on clinical protocols and guidelines.

6. Exceptional communication skills, both verbal and written, and the ability to interact with internal and external customers effectively.

7. Proven track record of delivering outstanding service and quality.

8. Ability to work in a fast-paced environment and handle multiple tasks simultaneously.

9. Strong computer skills, including proficiency in Microsoft Office Suite and other business applications.

10. In-depth knowledge of federal and state laws and regulations related to utilization management.

11. Ability to keep up-to-date with the latest trends and advancements in the healthcare industry.

Interested in hearing more? Easy Apply now by clicking the "Apply Now" button.

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