Temporary Utilization Review Assistant

Temporary Portland
  • Location: Portland
  • Type: Temporary
  • Job #19876

Temporary Utilization Review Assistant
Portland medical firm is looking for a temporary Utilization Review Assistant to join their busy team for up to 6 months.
Provide non-clinical support to the Utilization Management (UM) Team, including customer service, data entry, eligibility verification, and processing authorization requests. Ensure compliance with CMS, Tricare, and NCQA standards.

Key Responsibilities:

  • Respond to authorization requests and inquiries from members/providers via phone (8 AM–4:30 PM).
  • Screen, review, and process authorization requests per guidelines; upload documents to the system.
  • Generate required notifications and manage notification queues.
  • Distribute daily census information to facilities as needed.
  • Support departmental meetings and improvement initiatives.
  • Adhere to compliance standards and assist other non-clinical areas as required.

Qualifications:

  • Education/Experience: Associate’s Degree or equivalent; 2+ years in managed care/call center. Knowledge of CPT, ICD-10, and HCPCS coding is a plus.
  • Licenses/Certifications: Medical Assistant Certification (preferred).

Skills & Competencies:

  • Knowledge of medical terminology, healthcare benefits, and managed care plans.
  • Proficiency in Microsoft Word, Excel, and healthcare databases.
  • Familiarity with CMS/NCQA regulations (preferred).
  • Strong organizational, multitasking, and communication skills.
  • Ability to handle confidential information and work independently.
  • Problem-solving and critical-thinking abilities; collaborative mindset.
Onsite in Portland, Monday-Friday 8-4:30. $21-25/hr.


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