Administrative Assistant – Full Time, Days (Culver City)

Under the direction of the Director of Utilization Management, the Utilization Review Administrative Assistant directs all back-office functions of the Case Management Department. Interfaces with all payors/providers requesting authorizations, medical records, and other specific information. Confirms completeness of reviews to payors. Directs concurrent denials to appropriate local staff.

Responsibilities

• Interfaces with all payors and providers requesting authorizations, medical records, and other specific information. Completes payor and provider request for missing or additional documentation. Logs all authorization requests to ensure that they are submitted the same day as requested. Forwards all managed care/payor questions, correspondences and authorizations to the Director of Utilization Management (or designee). Ensures that all requests are handled appropriately and in a timely manner.
• Performs basic reception functions to ensure smooth office operations, including answering incoming calls, maintaining an accurate filing system, ensuring office supplies stocked to appropriate levels and office equipment serviced, copying forms and documents, etc. Types memos and other Utilization management documents as assigned. Effectively uses computer programs. Accurately collects and documents all necessary and required information and activities into the appropriate computer systems.
• Interfaces with outside agencies and payor services. Processes treatment authorization requests and forward to the Department of Mental Health IBHIS system. Completes admissions, discharge, TAR submissions and uploads documentation for daily review. Ensures that all patient privacy guidelines/laws are followed.
• Maintains audits for timely completion of Utilization Reviews. Completes audits for retroactive reviews and provides same day summary to Director of Case Management. Ensures that all reviews are completed and received by the payor in a timely manner.
• Maintains status and oversees required performance improvement data/documents for current PI/Quality indicators. Cross references multiple sources of data, ensuring that information is appropriately placed in patient’s medical records.
• Accurately collects data under the direction of the Leader of the Department and/or UR Committee members.

Qualifications

Southern Cali Hospital Culver City

Required Qualifications:

• High School Diploma or GED equivalent
• Knowledge of utilization management
• 2 years works experience
• Must demonstrate customer service skills appropriate to the job
• Computer literacy and proficiency
• Excellent written and verbal communication skills
• Ability to establish and maintain effective working relationships within the organization
• Ability to multitask and maintain a work pace appropriate to workload

Preferred Qualifications:

• N/A

Pay Rate: – Min $23.30 l Max – $32.00

About Us

Southern California Hospital at Culver City has been taking care of generations of Culver City and west LA residents. We are a full-service, acute care hospital with a 24/7 emergency department and nationally recognized patient safety. Now at 420 beds, SCH-CC is a general acute care hospital that utilizes many of the latest medical treatments and technologies. The hospital offers a wide range of inpatient and outpatient acute care services, including an orthopedic center, cardiovascular services, acute rehabilitation, sub-acute care, psychiatric care and chemical dependency programs. Additionally, SCH-CC operates a 24-hour emergency services center, which serves as a paramedic receiving station and is staffed by board-certified emergency physicians and nurse specialists.