Clinical Utilization Coordinator

4 weeks ago


Leesburg, Florida, United States UF Health Full time

Overview

UF Health Leesburg Hospital is a leading healthcare provider in the region, offering advanced cardiac care, orthopedic surgery, and emergency services. As a Denial Recovery Coordinator, you will play a critical role in managing and coordinating utilization and external review activities related to payor issues.

Responsibilities

  • Under the general supervision of the Utilization Management Director, you will be responsible for hospital-wide management and coordination of utilization and external review activities.
  • You will ensure an active and effective utilization and denial management program, in accordance with the utilization review plan, Federal and State guidelines, and The Joint Commission standards.

Qualifications

  • Bachelor's Degree preferred
  • Florida Registered Nurse license
  • Minimum 2 years' experience performing utilization review in a hospital setting, for a third-party payor or other review agency or organization
  • Knowledge of diagnostic related groups (DRGs), Federal and State guidelines, commercial and other payor groups, and ICD-10-CM coding preferred


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