Utilization Management Specialist (1.0 FTE/Days)
Franciscan AllianceWHAT WE NEED
Medical billing specialist
WHO WE ARE LOOKING FOR
The office staff behind a healthcare office is a busy place. Verifying coverage, coordinating schedules, managing pre-certification requests are all important tasks in support of the billing and insurance team. It requires the kind of person who is great on the phone and offers exceptional customer service. If you have experience with medical coding and billing, this could be the next job for you.
Are you a pleasant team player? Do you enjoy resolving problems? Are you a good communicator? Are you accurate and thorough in your work? We’d love to learn more about you.
WHAT YOU WILL DO
Contact insurance carrier after verifying information to secure benefit coverage, policy limitations, and pre-certification for patients.
Conduct follow-up calls necessary to physician offices and third party payor to complete pre-certification process.
Assist and cooperate in communicating and corresponding with patient compliance as needed.
Document and process financial and pre-certification request for patient referral.
Verify billing information from providers.
Enter authorizations in system.
WHAT IT TAKES TO SUCCEED
Knowledge of coding/medical billing procedures, health plans including BC/BS, Medicare, Medicaid, PPOs, HMOs.
Knowledge of medical billing software.
Strong customer service professional telephone skills.
Ability to interact with others in a calm, friendly and caring manner.
High attention to detail.
Strong organizational and analytical skills.
Ability to multi-task in a fast-paced environment.
Proficient computer skills
- Required High School Diploma/GED
- Required 1 year Utilization Management/HMO/PPO experience
TRAVEL IS REQUIRED:
EQUAL OPPORTUNITY EMPLOYER
It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law.
Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights.
Franciscan Alliance is committed to equal employment opportunity.
Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.