Utilization management specialist

- Act as the main contact for insurance-related inquiries and communications - Ensure efficient receipt and dispatch of documents by checking UM fax folders daily - Verify that clinical documentation is sent to payers for inpatient admissions and denials - Maintain precise records of all fax communications - Regularly monitor the Optum Portal to ensure all determinations are properly addressed and uploaded to EPIC - Obtain initial and ongoing inpatient authorizations from insurance providers - Track authorization requests and follow up as necessary with insurance companies - Confirm patients insurance coverage and benefits when requested - Document all communications with insurers in the EPIC system - Keep detailed records of authorization requests, approvals, and inpatient denials - Update the Utilization Review team on authorization statuses as needed - Maintain an up-to-date database of payer contact information - Perform accurate data entry within the EHR to ensure information integrity - Effectively manage multiple responsibilities in a dynamic environment - Prioritize tasks to meet departmental deadlines and requirements - Offer comprehensive administrative support to the Utilization Review team - Assist with other assigned duties and participate in the onboarding of new staff members as required