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Temporary Utilization Review Assistant

Maine Staffing Group
Portland, ME Temporary
POSTED ON 1/25/2025
AVAILABLE BEFORE 4/25/2025

Job Description

Job Description

Are you a detail-oriented, health industry enthusiast? Our Client in Portland is looking for a Temporary Utilization Assistant.

Location : Portland, Maine In-Person

Duration : 3-6 months

Hours : 8 : 00 am - 4 : 30 pm

Description :

  • Available on a phone queue between 8am and 430pm as needed to support the UM nurses as well as to receive authorization requests and answer general authorization questions from members and providers.
  • Manages multiple authorization queues by reviewing, screening, entering, and processing authorization requests from members and providers per HMD guidelines / workflows and contractual / regulatory standards. Uploads faxes to the medical management system. Education :
  • Associate’s degree or equivalent education and experience
  • Experience with CPT, ICD-10 and HCPCS coding a plus Required License(s) and / or Certification(s)

Experience :

  • 2 years of managed care experience including experience in a call center
  • Medical Assistant Certification a plus Skills / Knowledge / Competencies (Behaviors) :
  • Basic knowledge of medical terminology, current healthcare benefits and managed care insurance plans
  • Basic knowledge of Microsoft Word and Excel
  • Knowledge of CMS and NCQA regulations a plus
  • Demonstrated technical skills in use of office systems, electronic heath records, an databases
  • Strong organizational skills (ability to prioritize and multi-task in a high-pressure environment while maintaining focus on organizational objectives)

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