Utilization Mgmt Rep- Per Diem (As Needed)

Job description

Department: 11215 Advocate Aurora Health Corporate - Utilization Management Status: Part time Benefits Eligible: No Hou rs Per Week: 0 Schedule Details/Additional Information: 1 day /week and then potentially more based on staffing needs 1 weekend shift per month and 1 summer and 1 winter holiday Pay Range: $20.80 - $31.20 Major Responsibilities: Manage incoming fax, phone, and portal communications or any other requests from internal and external customers pertaining to clinical requests, approvals, authorizations, and denials; determine action required, and document all activities performed accurately and clearly in the designated database/area(s) of EHR. Communicate clinical needs, authorizations, and denials to the Utilization Review Nurses and Managers for follow up Verify insurance information provided by callers, fax, or Portal and send information to payers as requested, including discharge dates and disposition or clinical reviews/summaries prepared by UM RNs (if directed to do), while ensuring that all actions taken align/comply with the confidentiality and HIPAA compliance guidelines Follow up with payers to validate the authorization and confirm the days approved, and c...