This position is a Utilization Review Assistant within the Department of Care Coordination. As a member of an interdisciplinary department, this position will support the Utilization Review (UR) team to enhance efficiency, timely responsiveness to payor requests, and denial prevention. The primary responsibility of this position is supporting the UR team through managing and triaging communication from insurance payors via email, fax and phone inquiries pertaining to clinical requests, approvals, authorizations, and other payor requirements. This position will ensure UR timely response and submission of these requests to support the UR team's efficiency and payor communication management. Additionally, this position will support compliance requirements with CMS and other payor needs. This position will also identify areas for improved efficiency of administrative processes.
We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to
HR@insightglobal.com.
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* Two years' healthcare experience preferred.
* Ability to organize work and multi-task is required.
* Strong communication skills are required.
Benefit packages for this role will start on the 1st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.