Clinical Utilization Specialist

5 days ago


Torrance, California, United States Torrance Memorial Medical Center Full time
Job Summary

We are seeking a highly skilled and detail-oriented Utilization Review Assistant to join our team at Torrance Memorial Medical Center. As a key member of our Utilization Review department, you will play a critical role in ensuring that all utilization management documentation and information requirements are met.

Key Responsibilities
  • Provide support to the Utilization Review Manager in ensuring compliance with payer notification, authorization management, denial management, and other regulatory requirements.
  • Act as a liaison between the Utilization Review team, Business Office, and other hospital departments to facilitate clear communication and collaboration.
  • Assist with the coordination of department statistics and provide timely and accurate documentation to the budget department and director.
  • Ensure that all payer communication is accurate and up-to-date, including reference numbers and authorizations for benefits coverage.
  • Collaborate with other departments and teams to mitigate potential denials and ensure timely and accurate completion of payer and repatriation documentation.
Requirements
  • 2+ years of experience in a healthcare setting, preferably in utilization review, case management, or revenue cycle.
  • California Licensed Vocational Nurse (LVN) certification.
  • Strong communication and interpersonal skills, with the ability to work effectively in a team environment.
  • Ability to maintain confidentiality and handle sensitive information with discretion.
What We Offer

Torrance Memorial Medical Center offers a competitive compensation package, including a salary range of $36.31 per hour, as well as opportunities for professional growth and development in a dynamic and supportive work environment.



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