PreCert Technician
Universal Health Care - Saint Petersburg, FL

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A Utilization Management Technician (UM Tech) provides support to UM Nurse Case Managers, Concurrent Review and Precertification Nurses through data entry, filing and calling members or providers. A UM Tech is expected to perform all duties with integrity and within the parameters of all compliance rules and regulations. Is a vital part of the success of the Utilization Management department through the high level of support that is required from the position.

Position Responsibilities:
Data entry of pre-service requests and new in-patient hospital notifications

Data entry of clinical information

Perform and document hospital discharge calls

Notification of approved authorizations to providers

Assist Case Managers with member calls

Prepares and mails member educational materials

Check inbound call log in Fortuna for messages for Utilization Management department

Answers phone and voicemail in a professional and timely manner and refers to appropriate nurse

Other duties as assigned

Requirements and Preferences:
Prioritization and time management skills

Must be able to communicate, orally and in writing, clearly and succinctly to members, providers and internal partners

Ability to manage multiple tasks

Must be familiar with medical terminology and coding

Must treat all health information with confidentiality and discretion

Ability to work in a team environment and maintain professional relationships within the office setting

Strong work ethic and ability to work in a team atmosphere

High School Diploma, or equivalent, required

Certified Nursing Assistant, preferred

Experience in a hospital setting or doctors office, preferred

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