UM Technician
AmeriHealth Mercy Family of Companies - Washington, DC

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Position Summary:

The Utilization Management Tech functions under the direction of the Supervisor to coordinate, generate and track both incoming and outgoing correspondence, faxes and authorizations related to prospective, concurrent and post service review functions. Interacts with facilities, vendors, providers, and other staff to facilitate receipt of information, and /or records for prompt review and response. Compensation plans for physicians, licensed nurse reviewers, staff, and consultants who conduct medical management do not contain incentives, directly or indirectly, that encourage barriers to care and service in making determinations.

Position Qualifications/Requirements:

Education and Training:

High School Diploma or GED required.

  • Minimum 1 year general office and/or customer service experience required.
  • Work experience in healthcare setting required.
  • Knowledge of medical terminology required.

Key Competencies/Success Factors:
  • Understanding of the Healthcare delivery system
  • Knowledge of Medical terminology
  • Problem solving and organizational skills
  • Grammar / Proof reading skills
  • Ability to handle multiple tasks simultaneously
  • Customer service and interpersonal skills
  • Excellent oral and written communication skill
  • Proficient PC skills in a Windows based environment