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UM Review Assistant

Job in Falls Church, Fairfax County, Virginia, 22042, USA
Listing for: HireTalent
Full Time position
Listed on 2026-01-19
Job specializations:
  • Healthcare
    Healthcare Administration
  • Administrative/Clerical
    Healthcare Administration
Salary/Wage Range or Industry Benchmark: 80000 - 100000 USD Yearly USD 80000.00 100000.00 YEAR
Job Description & How to Apply Below

Title:

UM Review Assistant

Location:

CA (remote)
Duration: 6 months

Job Description:
  • Provide primary non-clinical program support by encompassing provider training, customer service, call triaging, authorization preparation, data entry, and the development and tracking of functions for members and providers.
  • Offer non-clinical support to other programs as needed, ensuring flexibility and adaptability in meeting organizational requirements.
  • Review patient records for completeness against submission requirements, identifying cases requiring additional non-clinical information.
  • Process and document case discharges with precision and timeliness.
  • Ensure accurate and prompt submission of all administrative-related documents to relevant parties.
  • Act as a liaison with internal and external customers, fostering positive and professional relationships to facilitate an effective review process.
  • Attend training and scheduled meetings, maintaining up-to-date information for case preparation.
  • Uphold medical records confidentiality through proper use of computer passwords and secured files, adhering to HIPAA policies.
  • Answer calls and demonstrate proper telephone etiquette and communication skills in alignment with Acentra Health's policies, procedures, and guidelines.
  • Cross-train to perform duties of other contracts within the Acentra Health network, contributing to a flexible workforce to meet client/consumer needs.
  • Fulfill other assigned duties to meet contract deliverables and organizational requirements.
  • Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules.
Required Qualifications
  • High school diploma or GED equivalent.
  • Associate degree preferred and/or equivalent work experience related to medical, behavioral, or social/support settings.
  • 1-2 years of experience in administrative or records management.
  • 2-3 years in an administrative support or customer service position and be familiar with healthcare.
Preferred Qualifications
  • Comprehensive knowledge of office environments and business processes.
  • Understanding of a customer service approach tailored for medical provider stakeholders.
  • Familiarity with government structures and related programs is advantageous.
  • Excellent communication skills.
  • Ability to multitask, prioritize, and provide service to a diverse range of customers.
  • Experience in development and project activities.
  • Experience in staff and provider training, with preferred public speaking skills.
  • A proactive approach to continually assess office functions and report potential issues to the Director.
  • Capability to track provider issues and report them appropriately.
  • Willingness to learn the Atrezzo application and assist customers in resolving technical issues related to the submission of Health Homes authorization requests.
  • Proficiency in Microsoft Office applications and Excel, ensuring efficient utilization of essential software tools.
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