Associate BPM Lead (Utilization Management Intake Analyst)
UST Global Inc
Job Summary: UST is searching for a Healthcare Utilization Management Intake Analyst who will support coordination of medical services including utilization management intake, requesting medical records, and provider requests to promote effective utilization of healthcare services. Promotes and supports utilization management team as required.
Provide support services to team members by answering incoming telephone calls, taking messages, researching information and building authorizations in the UM system Request medical records for pending authorizations or continued stay authorizations Generate UM letters for members and providers when authorizations are not required Refer to needed services in accordance to benefit plan Maintain accurate and complete documentation of required information that meets quality standards. Protect the confidentiality of the member information and adheres to the company policies regarding confidentiality Perform other duties as assignedQualifications:
High school diploma or G.E.D. equivalent required; associate or bachelor’s degree in health care related field an advantage Minimum of one year experience in a health care related field. Preferred setting is hospital, medical doctor’s office, or health insurance company. Experience with medical terminology and concepts used in the healthcare delivery system, provider office, or the insurance industry is required Computer literacy to include Microsoft Office products, Advanced technical skills for use of hardware and software with a high degree of accuracy Excellent oral and written communication skills for representation of clear and concise results Ability to manage significant workload, and to work efficiently under pressure, meeting established deadlines with minimal supervision Strong time management skills Must possess high degree of accuracy, efficiency, and dependability Strong customer service skills to assist members and/or providers with understanding healthcare information and to coordinate issue resolution Effective written and verbal communication and feedback Effective organizational skills with ability to be flexible and prioritize tasks Knowledge of educational assessments and learning strategies Must be knowledgeable of and able to use standard, basic grammar, punctuation, and spelling Amenable to work nightshift
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