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Utilization Management Specialist-MSH-Case Management-FT-Days

Company

Mount Sinai Health System

Location

New York, New York

Type

FULL_TIME


Description

Utilization Management Specialist MSH Case Management FT Days 


This position is responsible for coordinating requests for clinical information from third party payers and providing support to a broad client base, both internal and external to the institution. Position responsibilities will include utilization management support functions for patient admissions and continuing stay. This position also facilitates and tracks concurrent adverse determinations and collaborates with Appeals Management Department in managing retrospective denials.


Responsibilities
  • Admission: Payer Authorization & Denials Management. Communicate with payer to obtain request for clinical information, payer authorization and determination follows up at regular interval to ensure payer response. Coordinate peer to peers
  • Data Entry & Reporting. Responsible for all relevant communication with payers (time stamped) and entered into...
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