Role OverviewThe Utilization Management Specialist will support the concurrent and retrospective utilization management process by collaborating with payors, MedStar Financial Services, and Case Management staff to assure certification and payment of acute care days.
What You Will Do
Analyzes and interprets data to provide consistent, meaningful information for the Denials Management Team and specific service lines as indicated. Presents data in a comprehensive format to facilitate understanding and support the decision-making process.
Why It Might Be a Fit
Join one of the largest healthcare systems in the Baltimore-Washington metro region, also recognized as one of the 'Healthiest Maryland Businesses'.
Requirements
- High School Diploma or GED
- Knowledge of third-party reimbursement and medical terminology
- 2 years related experience
- 1 year experience in case management or utilization review
- Associate degree in business or healthcare field preferred
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