Utilization Review Assistant Description
Affiliated Computer Services, Inc. (ACS) is expertise in action™. We are a FORTUNE 500 company with 74,000 employees worldwide supporting client operations reaching more than 100 countries. We provide business process outsourcing and information technology solutions to world-class commercial and government clients. Our employees operate with integrity, and are flexible, reliable and responsive. If you meet the requirements of this position and want to work for a world-class company with a great marketplace reputation, apply today.
· Performs certifications based upon benchmarks, forwards non-benchmark requests to clinical staff for review.
· Assists review staff with certifications by reviewing information submitted that does not need medical necessity certification/non-certification; collection and transfer of non-clinical data; acquisition of structured clinical data; and activities that do not require evaluation or interpretation of clinical information. Certification of services that require clinical review are forwarded to licensed clinical staff for review
· Performs a variety of general administrative duties for the Review Department including (but not limited to):
o Calls hospitals to obtain status of patients on Inpatient Log. If patient is not discharged, obtains current status and requests update accordingly. If patient has been discharged; date of discharge is verified and retro review is requested if entire length of stay has not been certified.
o Distributes voicemail messages from the Review Department mailbox.
o Answers telephone calls to the Review Department
o Facilitates electronically filing/scanning of medical records in the appropriate format and location
· Adheres to URAC standards for accredited Utilization Review programs
Functional Description:
Provides support to the Review Department including certification of services/procedures based upon national benchmarks.
Education and Typical Years Experience
- High school diploma, general equivalency diploma (GED) or equivalent combination of education and experience.
- Completion of Medical Terminology course
· Minimum of one year experience in a Utilization Management or related setting.
All other duties as assigned.
ACS is an Equal Opportunity Employer and does not Discriminate against any applicant on the basis of race, color, religion/creed, national origin, gender, or sex, marital status, age, disability, use of a guide dog or service animal, sexual orientation, military/veteran status, or any other status protected by Federal or State law or local ordinance. People with disabilities who need a reasonable accommodation to apply or compete for employment with ACS may request such accommodations by calling 866-419-2226 .
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