Utilization Review (UR) Assistant

Utilization Review (UR) Assistant Long Beach, CA Job Details Full-time $21.00 - $25.91 an hour 1 day ago Qualifications Revenue cycle management Appeals Record keeping Utilization review Insurance claim appeals processing Filing High school diploma or GED Cerner Medical administrative support Medical records Case management Data entry Medical insurance appeals management Clerical experience Acute care 1 year Medical terminology Entry level Full Job Description This position supports the Mission of the Hospital through the provision of distinctive and compassionate care to our patients. This position provides clerical support to the Case Management Department by assuring continuous flow of daily activities; duties and information flow between all hospital departments and external customers. Perform various clerical tasks utilizing knowledge of office systems and procedures, facility regulations, and interdepartmental functions.

QUALIFICATIONS

High School graduate or GED preferred One year experience in an acute care hospital or related healthcare filed preferred Knowledge of medical terminology required

MAJOR TASKS, DUTIES, AND RESPONSIBILITIES

Responsible for processing all TARS in BHU after patient discharges Confirms MediCal TARS are completed for all dates of service and requests follow-ups from case managers as needed Prepare face sheets and print eligibility for patients and coordinates with HIM to request necessary medical records Submit MediCal TAR to MediCal field office via courier Prepares MediCal appeal decisions involving upheld denied days for further appeal Processes adjudication responses and appeal decisions from MediCal upon receipt to case management Completes data entry in revenue cycle of Cerner to document TARS submission Monitors MediCal case lists on a weekly basis to verify the status of TARS needed to be completed and status on TARS needing appeals and follow-up Assemble and maintain departmental files, logs, and manuals Placement in the pay range is based on multiple factors including, but not limited to, relevant years of experience and qualifications. In addition to base pay, there may be additional compensation available for CMC roles, including but not limited to shift differential and other special pay practices, etc. The posted compensation for the position is a reasonable estimate that extends from the lowest to the highest pay that CMC in good faith believes it might pay for this particular job, based on the circumstances at the time of posting.