GENERAL SUMMARY:
Responsible for supporting the Utilization Management team by assisting with obtaining documentation/signatures needed for insurance purposes and the ability to explain the documents to patients in our care. Monitors and records utilization activities of patients under the direction of Utilization Management. Ensures documentation is provided of insurance company requests or determinations. Collaborates in an interdisciplinary manner to optimize patient care, quality reimbursement and regulatory compliance.
PRINCIPAL JOB FUNCTIONS:
(Essential Job functions are marked with an asterisk “*”. Refer to the Job Description Guide for the definition of essential and non-essential job functions.) Attach Addendum for positions with slightly different roles or work-specific differences as needed.
REQUIRED KNOWLEDGE, SKILLS AND ABILITIES:
EDUCATION AND EXPERIENCE:
Licensure or certification in a field of medical or allied health area of study preferred. Minimum two (2) years clinical experience preferred.
OTHER CREDENTIALS / CERTIFICATIONS:
Basic Life Support (CPR) certification required. Bryan Health recognizes American Heart Association (for healthcare
professionals), American Red Cross (for healthcare professionals) and the Military Training Network.
PHYSICAL REQUIREMENTS:
(Physical Requirements are based on federal criteria and assigned by Human Resources upon review of the Principal Job Functions.)
(DOT) – Characterized as sedentary work requiring exertion up to 10 pounds of force occasionally and/or a negligible amount of force frequently to lift, carry, push, pull, or otherwise move objects, including the human body.
Equal opportunity
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, protected veteran status, or disability status. Bryan Health participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee’s Form I-9 to confirm work authorization.
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