What are the responsibilities and job description for the Utilization Review Assistant position at UChicago Medicine?
Job Description
Join UChicago Medicine, as a Utilization Review Assistant in the Care Coordination Department.
This position is a Utilization Review Assistant within the Department of Care Coordination. As a member of an interdisciplinary department, this position will support the Utilization Review (UR) team to enhance efficiency, timely responsiveness to payor requests, and denial prevention. The primary responsibility of this position is supporting the UR team through managing and triaging communication from insurance payors via email, fax and phone inquiries pertaining to clinical requests, approvals, authorizations, and other payor requirements. This position will ensure UR timely response and submission of these requests to support the UR team’s efficiency and payor communication management. Additionally, this position will support compliance requirements with CMS and other payor needs. This position will also identify areas for improved efficiency of administrative processes.
Essential Job Functions
We’ve been at the forefront of medicine since 1899. We provide superior healthcare with compassion, always mindful that each patient is a person, an individual. To accomplish this, we need employees with passion, talent and commitment… with patients and with each other. We’re in this together: working to advance medical innovation, serve the health needs of the community, and move our collective knowledge forward. If you’d like to add enriching human life to your profile, UChicago Medicine is for you. Here at the forefront, we’re doing work that really matters. Join us. Bring your passion.
UChicago Medicine is growing; discover how you can be a part of this pursuit of excellence at: UChicago Medicine Career Opportunities .
UChicago Medicine is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, ethnicity, ancestry, sex, sexual orientation, gender identity, marital status, civil union status, parental status, religion, national origin, age, disability, veteran status and other legally protected characteristics.
Must comply with UChicago Medicine’s COVID-19 Vaccination requirement as a condition of employment. If you have already received the vaccination, you must provide proof as part of the pre-employment process. This is in addition to your compliance with the Flu Vaccination requirement as well. Medical and religious exemptions will be considered consistent with applicable law. Lastly, a pre-employment physical, drug screening, and background check are also required for all employees prior to hire.
Compensation & Benefits Overview
UChicago Medicine is committed to transparency in compensation and benefits. The pay range provided reflects the anticipated wage or salary reasonably expected to be offered for the position.
The pay range is based on a full-time equivalent (1.0 FTE) and is reflective of current market data, reviewed on an annual basis. Compensation offered at the time of hire will vary based on candidate qualifications and experience and organizational considerations, such as internal equity. Pay ranges for employees subject to Collective Bargaining Agreements are negotiated by the medical center and their respective union.
Review the full complement of benefit options for eligible roles at Benefits - UChicago Medicine .
Join UChicago Medicine, as a Utilization Review Assistant in the Care Coordination Department.
This position is a Utilization Review Assistant within the Department of Care Coordination. As a member of an interdisciplinary department, this position will support the Utilization Review (UR) team to enhance efficiency, timely responsiveness to payor requests, and denial prevention. The primary responsibility of this position is supporting the UR team through managing and triaging communication from insurance payors via email, fax and phone inquiries pertaining to clinical requests, approvals, authorizations, and other payor requirements. This position will ensure UR timely response and submission of these requests to support the UR team’s efficiency and payor communication management. Additionally, this position will support compliance requirements with CMS and other payor needs. This position will also identify areas for improved efficiency of administrative processes.
Essential Job Functions
- Process incoming requests from internal and external customers and enter information into clinical database. Send information to payers as requested including discharge dates and discharge disposition. Send clinical information to payers as requested.
- Notify nurses of denial information and identify requested information
- Notify Insurance Verification (IV) Team for Notice of Admission rejections
- Notify IV of wrong insurance submissions
- Notify nurses of Appeals requests
- Submit all payor discharge summary requests
- Submit clinical information to the payor (only for resubmission requests of previously sent clinical information)
- AA’s will refax clinical information to correct payor fax number per payor request
- Notify the RN of requested or missing clinical information
- Enter admission approvals via Epic
- Effectively collaborates with payors and nursing teams to validate authorization and capture approved days for documentation in EPIC.
- Bachelor’s degree or equivalent experience preferred.
- Two years’ healthcare experience preferred
- Ability to organize work and multi-task is required.
- Strong communication skills are required.
- Job Type/FTE: 1.00 FTE Full time
- Shift: Days
- Unit/Department: Care Coordination-Hyde Park
- Work Location: Hyde Park
- CBA Code: Non-Union
We’ve been at the forefront of medicine since 1899. We provide superior healthcare with compassion, always mindful that each patient is a person, an individual. To accomplish this, we need employees with passion, talent and commitment… with patients and with each other. We’re in this together: working to advance medical innovation, serve the health needs of the community, and move our collective knowledge forward. If you’d like to add enriching human life to your profile, UChicago Medicine is for you. Here at the forefront, we’re doing work that really matters. Join us. Bring your passion.
UChicago Medicine is growing; discover how you can be a part of this pursuit of excellence at: UChicago Medicine Career Opportunities .
UChicago Medicine is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, ethnicity, ancestry, sex, sexual orientation, gender identity, marital status, civil union status, parental status, religion, national origin, age, disability, veteran status and other legally protected characteristics.
Must comply with UChicago Medicine’s COVID-19 Vaccination requirement as a condition of employment. If you have already received the vaccination, you must provide proof as part of the pre-employment process. This is in addition to your compliance with the Flu Vaccination requirement as well. Medical and religious exemptions will be considered consistent with applicable law. Lastly, a pre-employment physical, drug screening, and background check are also required for all employees prior to hire.
Compensation & Benefits Overview
UChicago Medicine is committed to transparency in compensation and benefits. The pay range provided reflects the anticipated wage or salary reasonably expected to be offered for the position.
The pay range is based on a full-time equivalent (1.0 FTE) and is reflective of current market data, reviewed on an annual basis. Compensation offered at the time of hire will vary based on candidate qualifications and experience and organizational considerations, such as internal equity. Pay ranges for employees subject to Collective Bargaining Agreements are negotiated by the medical center and their respective union.
Review the full complement of benefit options for eligible roles at Benefits - UChicago Medicine .
