Title: Utilization Review Assistant

Location: Long Beach

Department: Utilization Management

Status: Full time

Shift: Day

Pay Range*: $24.72/hr - $35.85/hr

At MemorialCare Health System, we believe in providing extraordinary healthcare to our communities and an exceptional working environment for our employees. Memorial Care stands for excellence in Healthcare. Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation, and teamwork.

Position Summary

The Utilization Review Assistant, using decision trees and standard work, determines appropriate chart documents and timely transmits the documents to government and private health plans to secure authorizations. The URA documents activities and authorizations per standard work.

The Utilization Review Assistant assures timely and accurate follow through of all office based systems needed to assist with the Utilization Management Department functions. The Utilization Review Assistant collaborates with the case managers and social workers to provide needed documentation and support for day to day Department needs. Fiscal responsibilities include functions to assure positive accounts receivable trends by processing and obtaining information required for authorizations. The Utilization Review Assistant receives supervision and direction from an assigned lead Resource Management Assistant for day to day activities.

Essential Functions and Responsibilities of the Job

1. Appropriate chart documents are chosen and transmitted per decision trees and standard work.

2. Chart documentation is transmitted per department timeliness requirements.

3. Documentation in the billing system of activities and authorizations is complete and timely.

4. Duties performed meet department productivity requirements.

5. Performs other duties as assigned.

*Placement in the pay range is based on multiple factors including, but not limited to, relevant years of experience and qualifications. In addition to base pay, there may be additional compensation available for this role, including but not limited to, shift differentials, extra shift incentives, and bonus opportunities. Health and wellness is our passion at MemorialCare-that includes taking good care of employees and their dependents. We offer high quality health insurance plan options, so you can select the best choice for your family. And there's more... Check out our MemorialCare Benefits for more information about our Benefits and Rewards. Qualifications/Work Experience:

• 2+ years medical office/UR Department/Admitting Central Auth Unit/medical group experience in utilization review, insurance contracts, multi-payer inpatient authorization systems and/or business office operations is required, or 2+ years' experience as a Licensed Vocational Nurse.

Education/Licensure/Certification:

• AA Degree and/or healthcare related certificate course preferred.