Employer: Change Healthcare
What will I be responsible for in this job? (brief summary of the role)
This position is a non-clinical position that is responsible for the administrative components of utilization management that primarily focuses on supporting the medical review process. The position is responsible for the coordination of medical reviews between the utilization review nurse and the health plan medical director(s)/peer reviewer(s). This can also include the post-payment medical review process. The position is responsible for the routing of clinical documentation based on the advanced knowledge base of the client’s business rules and workflow.
The position is also responsible for the review and triaging of claims and customer service inquiries. The position is responsible for authorization entry, indexing and routing of records, and review and resolution of escalated authorization issues. This position works closely with the case managers, utilization review nurses, and Health Services manager.
What are the requirements?
Years of experience:
- One year of healthcare experience as a medical assistant, healthcare utilization coordinator, unit secretary/clerk, medical records clerk or related experience.
Education:
- Required: High School Diploma or GED
- Preferred: Associates Degree (A.A. or equivalent from a two-year college or medical/technical school)
Physical requirements:
- Office/Home office environment
- Stable and strong internet connection
What critical skills are needed for you to consider someone for this position?
- Strong critical thinking and analytical skills
- Strong verbal and written communication skills are required
- Knowledge of healthcare
- Knowledge of medical terminology
- Excellent computer literacy and beginning to moderate skills level with Microsoft Office Suite
- Strong interpersonal skills
- Ability to function independently as well as in a group
- Adapt to changing environments, applications, and software
- Ability to multi-task
- High commitment to accuracy, quality of work, being organized, and detailed oriented
- Ability to navigate through multiple computer applications simultaneously
- Skilled at typing on a personal computer
What other skills/experience would be helpful to have?
- Ability to read and comprehend simple instructions, short correspondence, and memos.
- Ability to write simple correspondence.
- Ability to speak effectively to physicians, patients, families, and other members of the health care team.
- Strong organizational skills.
- Ability to add, subtract, multiply and divide into all units of measure, using whole numbers, common fractions, and decimals.
Hours: M-F 10:00am-6:30pm Central or 10:30am-7:00pm Central
Weekend coverage on a rotational basis.
Join our team today where we are creating a better coordinated, increasingly collaborative, and more efficient healthcare system!
COVID Vaccination Requirements
We remain committed to doing our part to ensure the health, safety, and well-being of our team members and our communities. As such, we require all employees to disclose COVID-19 vaccination status prior to beginning employment and we may require periodic testing for certain roles. In addition, some roles require full COVID-19 vaccination as an essential job function. Change Healthcare adheres to COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance.
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.
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.
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.
Change Healthcare maintains a drug free workplace and conducts pre-employment drug-testing, where applicable, in accordance with federal, state and local laws.