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Prospect Medical Holdings, Inc. · 1 day ago

Administrative Assistant - Full Time, Days (Culver City)

Culver City, CA

Full-time

Onsite

Entry Level

$23.30/hr - $32/hr

2+ years exp

Prospect Medical Holdings, Inc. is a healthcare provider operating Southern California Hospital at Culver City, which offers a wide range of acute care services. The Utilization Review Administrative Assistant will manage back-office functions, interface with payors and providers, and ensure timely processing of authorizations and reviews.

Hospital & Health Care

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