Brief Summary of the Position
To assist Inpatient Utilization Management RN’s and Unit Assistant by completing data entry and collaborating with insurance companies.
Responsibilities and Expectations
- Running discharge report and notifying insurance company of the discharge.
- Emailing denial letters to physicians, maintain denial spreadsheet, follow up on P2P’s and document outcomes and notifications in denial tab.
- Ability to multitask phone calls, emails, and faxes.
- Call insurance company for approvals
- Scheduling and obtaining prior auth for OP testing, labs, infusion ect.
- Obtaining prior authorization for post\-acute services
- Ability to interact with patients, employees, and other occupants in an appropriate manner.
- Moon forms/CC44 compliance. Provide moon forms for surgeries, direct admits, status changes and transfers. Provide a copy to the patient, original copy placed in chart and document completion of the moon form/CC44 in Cerner. Occasional mailing of moon form via certified mail.
- Utilizing payer websites for approvals, prior authorization, and denials.
- Keep up to date on payer policies.
- Covering Unit Assistant PTO
- Assist Unit Assistant with faxes, approvals, and Kronos as needed.
- Ability to receive, understand, and implement direction from supervision and management.
- Ability to effectively function within the framework of department and organizational policies and procedures.
- Other duties as assigned by the Director or designee.
- High School Diploma or equivalent
- Proficiency with Microsoft Office Suite (Outlook, Word, Excel, PowerPoint)
- Basic data entry and data management skills with strong attention to detail
- Comfortable using email, calendars, virtual meeting tools, and internal communication platforms
- Ability to navigate and learn new software systems quickly; almost all duties of this position are electronic in nature
- Aultman Hospital Main Campus
Education/Experience Requirements
Job Location
Location: Aultman Health Foundation · DISCHARGE SERVICES
Schedule: Full Time, Day Shift, 8:00am\-4:30pm