Utilization Review Coordinator conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Monitors patient charts and records to evaluate care concurrent with the patients treatment. Being a Utilization Review Coordinator reviews treatment plans and status of approvals from insurers. Collects and complies data as required and according to applicable policies and regulations. Additionally, Utilization Review Coordinator consults with physicians as needed. May require a bachelor's degree. Typically reports to a supervisor. Typically requires Registered Nurse(RN). The Utilization Review Coordinator contributes to moderately complex aspects of a project. Work is generally independent and collaborative in nature. To be a Utilization Review Coordinator typically requires 4 to 7 years of related experience. (Copyright 2024 Salary.com)
Coastal Harbor Health is currently seeking a Utilization Review Coordinator ( Fulltime ) To coordinate and direct Utilization Review functions, monitoring the utilization and continuum of services to optimize reimbursement.
Coastal Harbor Health System is comprised of a 114-bed hospital for children and adolescents, providing both short- and long-term inpatient care, and a 50 bed inpatient hospital serving men and women, ages 18 and up. We offer compassionate patient care to those who need it the most, serving not only local patients, but also those located across the country. Our hospitals are conveniently located in beautiful, historic Savannah, GA in a quiet setting that provides unparalleled anonymity and privacy, enabling patients to concentrate on treatment.
Job Duties/Responsibilities:
Perform the utilization and review process, for continued stay, in an appropriate and timely manner.
Maintain appropriate records of the review process for the purpose of preparing and submitting appeals to third party payors.
Respect the confidentiality of patient and employee information.
Maintain appropriate records of the review process for the purpose of preparing and submitting appeals to third party payors.
Supervise the reception of requests for information from medical records of patients in person, by mail or phone, from various sources from the community at large, and assures that authorizations are properly executed (according to HIPAA guidelines, federal, and state laws) for these requests for client information.
Perform other duties related to the department as necessity dictates.
Benefit Highlights:
One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $13.4 billion in 2022. During the year, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; and listed in Forbes ranking of America’s Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 94,000 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com
EDUCATION and/or EXPERIENCE
EEO Statement
All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.
We believe that diversity and inclusion among our teammates is critical to our success.
One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $13.4 billion in 2022. During the year, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; and listed in Forbes ranking of America’s Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 94,000 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com
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