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Inpatient Utilization Review Technician in Indianapolis, IN at Eskenazi Health

Date Posted: 1/8/2019

Job Snapshot

  • Employee Type:
    Full-Time
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:
    1/8/2019

Job Description

JOB SUMMARY:

 

The Inpatient Utilization Review Technician interacts with customers in a caring and respectful manner in accordance with Eskenazi Health Services' Core Values. The Technician acts as a patient information liaison and interfaces with Transitional Support staff, providers and specialists to assist in problem-solving. 

ESSENTIAL JOB FUNCTIONS:

Interacts with all internal and external customers in a caring and respectful manner in accordance with Eskenazi Health Services' Core Values.

Performs pre-certification activities related to inpatient services in accordance with predetermined departmental criteria.

Acts as a patient information liaison between business partners and contracted vendors.

Handles a variety of confidential data and documentation involving Transition Support Department Utilization Review members, patients and physicians; as well as confidential departmental and hospital information.

Interfaces with Transition Support staff, providers, and specialists to assist in problem-solving.

Maintains open communication regarding current status of departmental operations.

Operates within program requirements in accordance with CMS standards.

Determines validity of coverage following established authorization requirements and refers to the UR Case Manager for further determinations of coverage, as needed.

Compiles data for confidential/statistical reports.

Performs administrative duties for respective work area in a wide variety of non-routine situations.

Receives and screens phone calls, directing them to the UR Case Manager when appropriate.

Responds to inquiries regarding benefits and authorizations, etc.

Receives and maintains departmental files and records.

JOB REQUIREMENTS:

 

High school diploma or General Equivalency Diploma (GED)

1-2 years of experience in a healthcare-related position preferred

Knowledge of computer and related software

Medicaid experience preferred