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Utilization Insurance Specialist
2 months ago
We are seeking a highly skilled Utilization Insurance Specialist to join our team at Mount Sinai Health System. As a key member of our Utilization Management department, you will play a critical role in ensuring that our patients receive the necessary care and services while minimizing unnecessary costs.
Responsibilities- Conduct thorough reviews of medical admission records and continued stays to ensure appropriateness and timeliness of services
- Develop and maintain relationships with clinicians, insurance providers, and other stakeholders to ensure seamless communication and coordination
- Coordinate insurance authorizations and approvals, including pre-certifications and denials
- Monitor and analyze data to identify trends and areas for improvement in utilization management
- Collaborate with the UM Manager and other team members to develop and implement strategies to optimize patient care and reduce costs
- Masters degree preferred with experience in a related field
- Strong analytical and problem-solving skills, with ability to work in a fast-paced environment
- Excellent communication and interpersonal skills, with ability to work effectively with diverse stakeholders
- Proficiency in MS Word, Excel, and Access, with ability to learn new software applications
Mt Sinai Health System is a leading academic medical center that is committed to delivering exceptional patient care and advancing the field of medicine through research and education. We are an equal opportunity employer and welcome applications from diverse candidates.
