Utilization Review Manager - Home Care jobs in Rhode Island

Utilization Review Intake Specialist

HealthComp

Remote, United States

Now is the time to join us!

Virgin Pulse and HealthComp are now Personify Health. The industry’s first personalized health platform company combines health, wellbeing, and navigation solutions to deliver powerful outcomes to businesses and their people.

At Personify Health, we believe in offering total rewards, flexible opportunities, and a diverse inclusive community, where every voice matters.

Together, we’re shaping a healthier, more engaged future.

In this role you will wear many hats, but your knowledge will be essential in the following :

• Answer and route all incoming phone calls.
• Provide accurate information to internal and external customers regarding pre-certification process, including gathering demographic, non-clinical, and / or provider data for pre-certification via phone, fax, inter / intranet,
• Eldorado / Case Pac computer programs.
• Review service requests and manage the requests as efficiently as possible involving the appropriate department as needed.
• Perform data entry and maintain complete documentation of case information; assist in document maintenance or revisions;

compile monthly reports; maintain logs and files.

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

What you bring to the Personify Health team :

In order to represent the best of what we have to offer you come to us with a multitude of positive attributes including :

• Associate degree preferred in business, management, or related field.
• Prior experience in customer service and / or medical background.
• Prior insurance and / or claims background
• Prior experience in a medical front office or hospital patient intake, medical claims processing, or an equivalent combination of education and experience.

You also take pride in offering the following Core Skills, Competencies, and Characteristics :

• Strong written and verbal communication skills.
• Ability to manage high volumes of customer service calls.
• Proficient in Microsoft Excel, Word, and Outlook.
• Ability to organize, prioritize, and multitask in a fast-paced / deadline driven environment.
• Demonstrate ability to work independently with excellent judgment.
• Accurate data entry skills (40wpm)
• Knowledge of medical terminology; ICD-10, CPT & HCPCS coding desirable.

No candidate will meet every single desired qualification. If your experience looks a little different from what we’ve identified and you think you can bring value to the role, we’d love to learn more about you!

Personify Health is an equal opportunity organization and is committed to diversity, inclusion, equity, and social justice.

In compliance with all states and cities that require transparency of pay, the base compensation for this position ranges up to $23.

00 per hour. Note that salary may vary based on location, skills, and experience. This position is eligible for health, dental, vision, mental health and other benefits.

Last updated : 2024-06-01