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Utilization Review Coordinator

Date Posted: 5/23/2017

Job Description

Entrust Your Career to HealthTrust! 

As HealthTrust Workforce Solutions, we focus on a healthcare facility’s most valuable resource for delivering exceptional patient experiences – its people. We believe healthcare isn’t defined by the four walls in which it’s practiced. It’s defined by the people for whom and by whom it is delivered.

Fantastic opportunity for a Utilization Review Coordinator located in a beautiful facility near Orlando, Florida.

The Utilization Review Coordinator is responsible for determining the appropriateness of hospital admission; utilization of resources and medical necessity for continued stay; facilitates timely discharge; assures medical documentation accurately reflects the patient’s severity of illness; provides appropriate interventions and discharge planning services to the patients and families in collaboration with Case Management. The Utilization Coordinator will oversee the gathering of required clinical information and reports to insurance company’s regarding patient’s progress and plan to receive authorization for continued stay.  Confirms payor authorization and timely submits request for additional information. The Utilization Coordinator will review post discharge, prebill accounts that do not have an authorization on file, length of stay versus days authorized variances, and/or other account discrepancies that will result in account being denied by the payor that require clinical expertise.  Communicates with third party payors to resolve discrepancies prior to billing

Qualifications:

  • BSN required, MSN preferred
  • Current Florida RN license required
  • BLS for Healthcare providers preferred
  • 5 years clinical experience

Experience:  Current working knowledge of Utilization management, performance improvement and reimbursement issues, preferred.  Utilization review, Case Management, appeals, denials, managed care contracting experience preferred Requires excellent observation skills, analytical thinking and problem solving as well as excellent communication skills.

Special Skills/Qualifications:  Knowledge of Medical Center’s on-line PFS Data System and Applications. Training related to management & leadership, Customer Service, PC/CRT, Hospital PFS Software Applications; Third Party Billing; Electronic Claims Submission and Payment Processing , Word Processing, General Business Office Equipment, Electronic Claims Processing and Cash Processing; Management/Leadership, Time Management, Organizational Skills; and Communication Skills.  

Full benefits included! 

Together with our healthcare facility partners, we ensure that healthcare professionals have the skills, tools and support needed to fulfill their mission of delivering exceptional patient experiences. This means taking a holistic, long-term view of your career options and taking as good a care of our people as our hospital partners take of their patients. When healthcare professionals are empowered with the right skills, tools and employment opportunity to fulfill their mission – something incredible happens. Patient satisfaction soars, employee collaboration takes hold and healthcare organizations deliver high quality, sustainable access to care.

Apply today!

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Job Snapshot
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Employee Type:
Full-Time

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Location:
Leesburg, FL

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Job Type:
Health Care, Nurse

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Experience:
Not Specified

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Date Posted:
5/23/2017


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