Temporary Utilization Review Assistant

Portland, ME 04103

Posted: 01/20/2025 Employment Type: Contract Industry: Talent Skills Job Number: AB25894218 Pay Rate: $21.53-27.86 / hour

Job Description

Are you a detail-oriented, health industry enthusiast? Our Client in Portland is looking for a Temporary Utilization Assistant. 
Location: Portland, Maine  In-PersonDuration: 3-6 monthsHours: 8:00 am - 4:30 pm
  Description:
  • Available on a phone queue between 8am and 430pm as needed to support the UM nurses as well as to receive authorization requests and answer general authorization questions from members and providers.
  •  Manages multiple authorization queues by reviewing, screening, entering, and processing authorization requests from members and providers per HMD guidelines/workflows and contractual/regulatory standards. Uploads faxes to the medical management system. Education:
  •  Associate’s degree or equivalent education and experience
  •  Experience with CPT, ICD-10 and HCPCS coding a plus Required License(s) and/or Certification(s)
Experience:
  • 2 years of managed care experience including experience in a call center                 
  •  Medical Assistant Certification a plus Skills/Knowledge/Competencies (Behaviors):
  •  Basic knowledge of medical terminology, current healthcare benefits and managed care insurance plans
  •  Basic knowledge of Microsoft Word and Excel
  •  Knowledge of CMS and NCQA regulations a plus
  •  Demonstrated technical skills in use of office systems, electronic heath records, an databases
  •  Strong organizational skills (ability to prioritize and multi-task in a high-pressure environment while maintaining focus on organizational objectives)

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Adrijana Bukarac

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About Portland, ME

Discover exciting job opportunities in the vibrant Portland, Maine area! Known for its picturesque coastal charm, bustling Old Port district, and thriving arts scene, Portland is a city brimming with career possibilities and growth potential. From the renowned Portland Museum of Art to the eclectic array of seafood eateries along Commercial Street, there's no shortage of charm and culture to explore. Home to the Portland Symphony Orchestra, Portland Stage Company, and iconic Hadlock Field where fans cheer for the Portland Sea Dogs, this region offers a perfect blend of work and play. Dive into our job listings today and consider kickstarting your career in this enchanting city by the sea.