Temporary Utilization Review Assistant

Temporary Portland

• Location: Portland
• Type: Temporary
• Job #19876

Temporary Utilization Review Assistant
Portland medical firm is looking for a temporary Utilization Review Assistant to join their busy team for up to 6 months.
Provide non-clinical support to the Utilization Management (UM) Team, including customer service, data entry, eligibility verification, and processing authorization requests. Ensure compliance with CMS, Tricare, and NCQA standards.

Key Responsibilities:

• Respond to authorization requests and inquiries from members/providers via phone (8 AM–4:30 PM).
• Screen, review, and process authorization requests per guidelines; upload documents to the system.
• Generate required notifications and manage notification queues.
• Distribute daily census information to facilities as needed.
• Support departmental meetings and improvement initiatives.
• Adhere to compliance standards and assist other non-clinical areas as required.

Qualifications:

• Education/Experience: Associate’s Degree or equivalent; 2+ years in managed care/call center. Knowledge of CPT, ICD-10, and HCPCS coding is a plus.
• Licenses/Certifications: Medical Assistant Certification (preferred).

Skills & Competencies:

• Knowledge of medical terminology, healthcare benefits, and managed care plans.
• Proficiency in Microsoft Word, Excel, and healthcare databases.
• Familiarity with CMS/NCQA regulations (preferred).
• Strong organizational, multitasking, and communication skills.
• Ability to handle confidential information and work independently.
• Problem-solving and critical-thinking abilities; collaborative mindset.