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Utilization Review Specialist

2 months ago

Milwaukee, Wisconsin, United States Universal Health Services Full time
Job Title: Utilization Review Coordinator

Granite Hills Hospital is seeking a skilled Utilization Review Coordinator to ensure appropriate reimbursement by third-party payers. This role involves managing the denial/appeals process and coordinating with various stakeholders to optimize healthcare services.

Key Responsibilities:
  • Conduct thorough reviews of patient records to determine medical necessity and appropriateness of care
  • Communicate with payers, providers, and patients to resolve billing and reimbursement issues
  • Develop and implement strategies to reduce denials and improve revenue cycle efficiency
  • Collaborate with the healthcare team to ensure seamless coordination of care
Requirements:
  • Strong analytical and problem-solving skills
  • Excellent communication and interpersonal skills
  • Ability to work in a fast-paced environment and prioritize multiple tasks
  • Knowledge of healthcare regulations and reimbursement guidelines

Universal Health Services is committed to providing high-quality patient care and exceptional service. If you are a motivated and detail-oriented professional looking for a challenging role, please submit your application.