Newport News, Virginia
Overview
Provides administrative support to the Utilization Management team, including delivery of multiple Medicare & other insurance required forms to patients in a timely manner.
Thoroughly documents all updates on accounts in the electronic medical record, including communications with insurance companies, requests for clinical updates, denials received, and others as needed.
Assists in managing all work queues assigned to Utilization Management to ensure timely follow up on accounts.
What you will do
Ensures seamless communication with payers. Retrieves voicemails and faxes for the department and transcribes the information into the electronic medical record.
Communicates in a positive, professional manner at all times.
Diligently manages all clinical review work queues assigned to Utilization Management. Follows up on accounts in a timely manner, ensuring communications with payers are documented thoroughly.
Closes accounts as soon as feasible in order for Revenue Cycle to process claims. Communicates excessive delays to the Utilization Management team.
Administers all Virginia State Observation letters & Medicare Outpatient Observation Notice (MOON) to patients within one calendar day of being placed in an observation or outpatient status.
Must have the ability to answer general questions about these forms and document delivery in the electronic medical record, including all exceptions.
Scans copies into the electronic medical record.
Promotes teamwork by working effectively as a team member as well as independently. Communicates and collaborates with multiple team members, including Utilization Management RNs, care managers, nursing unit staff, unit secretaries, insurance representatives, and others as needed.
Seeks assistance as needed. Consistently keeps team informed of changes as they arise.
Assists the Director and other members of the Utilization Management team in administrative duties, to include mailing appeal letters, scanning and uploading information into the electronic medical record, and ordering office supplies as needed.
Takes minutes at team meetings.
Qualifications
Education
- High School Diploma or GED, with 3 years healthcare experience (Required) or
- Associates Degree, Healthcare / Business Administration or Related (Required)
Experience
2 years healthcare experience (Preferred)
To learn more about being a team member with Riverside Health System visit us at .
Utilization Review Assistant
Diligently manages all clinical review work queues assigned to Utilization Management. Provides administrative support to the Utilization Management team, including delivery of multiple Medicare & other insurance required forms to patients in a timely manner. Assists in managing all work queues assi...
Registered Nurse (RN) - Nights - $5,000 HIRING BONUS - Urgently Hiring!
Full-time Registered Nurse (RN) - Newly Opened Hospital!. Assumes role of Charge Nurse when assigned. ...
Locum Certified Registered Nurse Anesthetist (CRNA) in Erie, PA - Excellent Benefits 2024-10-01
LocumJobsOnline is working with LocumTenens.Anesthesiology CRNA in Erie, Pennsylvania, 16501!.A busy hospital is seeking a CRNA for locum tenens coverage.Relax on the beaches of Presque Isle State Park or take a tour of the Erie Maritime Museum and U.Enjoy outdoor activities like fishing, boating, a...
Travel Registered Nurse - OR - $1,946 per week in Scranton, PA
As an Operating Room Registered Nurse (OR RN), you will play a crucial role in the surgical team, providing direct patient care before, during, and after surgical procedures. ...
Travel Registered Nurse - ICU/Critical Care - $1,711 per week in Philadelphia, PA
TravelNurseSource is working with NuWest Group to find a qualified ICU/Critical Care RN in Philadelphia, Pennsylvania, 19128!. Travel nurses can bring fresh perspectives to healthcare facilities, contributing ideas and insights that may lead to improvements in patient care, safety, and overall healt...
Travel Registered Nurse - Interventional Radiology - $2,436 per week in York, PA
Travel Nursing: Interventional Radiology York, PA.Location: York, PA.Start Date: 10/14/2024.Shift Details: 12H Variable (12:00 AM-12:00 PM).Length: 13 WEEKS 13 weeks.Apply for specific facility RN....
Travel Registered Nurse - Stepdown - $1,898 per week in York, PA
Coast Medical Service is a nationwide travel nursing & allied healthcare staffing agency dedicated to providing an elite traveler experience for the experienced or first-time traveler.Coast is featured on Blue Pipes' 2023 Best Travel Agencies and named a 2022 Top Rated Healthcare Staffing Firm &...
Survey Project Manager
A Project Manager requires sufficient technical and professional management experience to demonstrate competence as an overall project team manager and leader for small to medium sized and moderately complex projects. A Project Manager is required to represent the organization in conferences and mee...
Project Manager Global Operations and Services
Oversees all aspects of planning, design, and execution of assigned small, routine projects and coordinates with project stakeholders to define project scope, goals, and deliverables. Project Manager Global Operations and Services. The UCIS Global Partnerships team is seeking a Project Manager for G...
Director of Nursing
Graduate of an accredited Diploma, Associate, or Bachelor’s School of Nursing, or vocational nursing. Director of Nursing Responsibilities. Director of Nursing Qualifications. Proof of current CPR certification . ...