Utilization Management Assistant

This is a fully remote position, open to applicants in Iowa.

📋 Description

• Respond to first-level calls related to Utilization Review for Health & Wellness participants.

• Assess certification requests by analyzing group-specific criteria.

• Direct calls to determine if a Utilization Review Nurse is necessary.

• Examine medical records.

• Collaborate with healthcare providers.

• Guarantee that patients receive suitable, cost-effective care in line with clinical guidelines and insurance standards.

⛳️ Requirements

• CNA, LPN, or Medical Assistant credentials are preferred.

• Experience in patient health support or care is essential.

• A minimum of 1 year of experience in this field is required.

• Excellent interpersonal skills to engage with patients, doctors, internal team members, and providers.

• A friendly demeanor with the capacity to communicate sensitive information to members.

• Precision and attention to detail when reviewing pre-certifications and plans.

• Prior experience in a medical environment, such as a receptionist, scheduler, insurance verification, LPN, CNA, Medical Assistant, or customer service role.

🏝️ Benefits

• Medical, Dental, and Vision Insurance.

• Flexible Spending Account or Health Savings Account.

• 401(k) plan with company matching.

• Profit-Sharing/Defined Contribution (with a 1-year waiting period).

• Paid Time Off and Paid Holidays.

• Company-paid Short Term and Long Term Disability.

• Maternity Leave and Parental Leave.

• Subsidized Parking.

• Company-paid Term Life and Accidental Death Insurance.

• Daytime office hours with weekends and holidays off.

• Most benefits commence on the first day of employment.