Utilization Review Assistant

Enter authorization requests based on information received in preparation for initial clinical review.

Authorizes referrals within authority guidelines and department standards for outpatient, inpatient, and ancillary services.

Responsible for answering all incoming calls to the Health Services Department. Makes outbound calls for follow-up inquiries or request for services.

Maintain knowledge of URAC utilization review standards

Competencies:Strong critical thinking and Analytical

Strong verbal and written communication skills

Knowledge of healthcare

Medical terminology

Excellent computer literacy and beginning to moderate skills level with Microsoft Word and Excel

Strong interpersonal skills

Able to work independently

MINIMUM JOB QUALIFICATIONSEducation / Training:High School Diploma or GED. Associate degree (A.A. or equivalent from two- year college or Medical/technical school preferred).

Six months to one year of related experience preferred if no formal education beyond high school.

SPECIALIZED KNOWLEDGE / SKILLSKnowledge of CPT, ICD-10, and/or HCPC codes or coding experience

Knowledge of precertification and/or medical review processes in a health care payor or third party environment.

WORKING CONDITIONS:Office Environment, office cubicle, indoors, heated/air-conditioned office

No heavy lifting of anything greater than 10 pounds and no extensive standing. Uses personal computer, copy machine, and fax machine on a regular basis.

Join our team today where we are creating a better coordinated, increasingly collaborative, and more efficient healthcare system!

COVID MandateAs a federal contractor, Change Healthcare is adhering to the Executive Order which mandates vaccination. As such, we are requiring all U.S. new hires and employees to show proof of being fully vaccinated for COVID-19 or receive an approved accommodation by their date of hire, as a condition of employment. As we continue to navigate the ever-changing COVID-19 pandemic, we remain committed to doing our part to ensure the health, safety, and well-being of our team members and our communities. Proof of vaccination or accommodations requests will be collected once an offer is accepted with Change Healthcare. All accommodation requests will be carefully considered but are not guaranteed to be approved. Equal Opportunity/Affirmative Action Statement Change Healthcare is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information, national origin, disability, or veteran status. To read more about employment discrimination protections under federal law, read EEO is the Law at https://www.eeoc.gov/employers/eeo-law-poster and the supplemental information at https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCPEEOSupplementFinalJRFQA508c.pdf.If you need a reasonable accommodation to assist with your application for employment, please contact us by sending an email to applyaccommodations@changehealthcare.com with "Applicant requesting reasonable accommodation" as the subject. Resumes or CVs submitted to this email box will not be accepted.Click here https://www.dol.gov/ofccp/pdf/pay-transp%20EnglishformattedESQA508c.pdf to view our pay transparency nondiscrimination policy.California (US) Residents: By submitting an application to Change Healthcare for consideration of any employment opportunity, you acknowledge that you have read and understood Change Healthcare’s Privacy Notice to California Job Applicants Regarding the Collection of Personal Information (https://www.changehealthcare.com/privacy-notice/privacy-notice-to-california-job-applicants) . Change Healthcare maintains a drug free workplace and conducts pre-employment drug-testing, where applicable, in accordance with federal, state and local laws.Change Healthcare is an equal opportunity employer. All qualified applicant will reveive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information, national origin, disability, or veteran status.