Utilization Review

1 week ago

Fort Lauderdale, United States Robert Half Full time
Job DescriptionJob DescriptionWe are offering a contract for a Utilization Review (UR) Records Analyst (ABA) position in Lauderdale Lakes, Florida. This role is primarily within the healthcare industry and requires the successful candidate to be physically present in the office. The primary function of this role is to handle customer applications, maintain customer records, and address customer inquiries, with a strong emphasis on understanding and applying insurance terminologies.

Responsibilities:

• Handle multiple tasks and deadlines with excellent organizational and time management skills.
• Collaborate effectively with clinical teams, insurance providers, and other stakeholders demonstrating strong communication skills.
• Process customer credit applications accurately and efficiently using your knowledge of insurance authorization processes and payer requirements.
• Demonstrate proficiency in Microsoft Office Suite and EHR software like Epic, Cerner, etc.
• Maintain accurate customer credit records, demonstrating a strong attention to detail and the ability to accurately analyze and process clinical records and documentation.
• Familiarize yourself with regulatory compliance standards, payer requirements, and utilization review processes.
• Work independently after training, showcasing critical thinking skills and the ability to handle strict deadlines.
• Communicate with insurance companies as needed, demonstrating excellent customer service skills.
• Use your knowledge of ABA therapy principles and treatment methodologies, although this is not a strict requirement.
• Experience with claim administration, collection processes, benefit functions, and billing functions will be beneficial.• Proficiency in ADP - Financial Services is required for effective financial management and reporting.
• Knowledge of Customer Relationship Management (CRM) tools is mandatory for managing client interactions.
• Familiarity with Dynamic Data Exchange (DDE) is needed for efficient data interchange and communication between applications.
• Proficiency in e-Copy is necessary for managing electronic copies of documents.
• Experience with EHR SYSTEM is needed for efficient health records management.
• Ability to handle Appeals effectively is crucial for resolving disputes.
• Understanding of Benefit Functions is necessary for managing employee benefits.
• Knowledge of Billing Functions is required for accurate and efficient billing processes.
• Experience in Claim Administration is needed for managing and processing claims.
• Familiarity with Collection Processes is necessary for effective management of payments and debts.

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