Utilization Review Specialist

1 day ago

Newark, Delaware, United States Rockford Center Full time $60,000 - $90,000 per year

Utilization Review Coordinator Opportunity

This opportunity is for a dynamic and talented Utilization Review Coordinator for a growing hospital and offers PRN/Per diem schedule.

Postion Summary: The incumbent will be responsible for proactively monitoring utilization of continuum services and optimizing reimbursement.

Key Responsibilities include:

  • Conduct admission reviews working with Assessment and Referral Services to stay abreast of admissions.
  • Conduct concurrent and extended stay reviews on appropriate day and/or specified time.
  • Prepare and submit appeals to third party payors, effectively coordinating collection of all pertinent data to support the hospital and patient's position.
  • Call/fax discharge information to insurance companies within 24 hours of discharge to ensure the facility is paid for the hospital stay.
  • Maintain and update logs of review and maintain other appropriate records of the Utilization Review department.
  • Communicate pertinent third party payors issues to doctor and treatment team.
  • Attend daily treatment team meetings to discuss acuity issues, third party payors needs and gather information for reviews.
  • Work independently in gathering information for reviews from the patient record, taking the initiative to seek information from members of the treatment team.
  • Understand and communicate insurance information to team members, including benefits and levels of care offered.

Benefits for a Utlilization Review Coordinator include:

  • Challenging and rewarding work environment
  • Competitive Compensation & Generous Paid Time Off
  • Excellent Medical, Dental, Vision and Prescription Drug Plans
  • 401(K) with company match and discounted stock plan
  • SoFi Student Loan Refinancing Program
  • Career development opportunities within UHS and its 300+ Subsidiaries
  • Tuition Assistance

About Universal Health Services (UHS):

One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, our annual revenues were $10.77 billion in 2018. In 2020, UHS was again recognized as one of the World's Most Admired Companies by Fortune; in 2019, ranked #293 on the Fortune 500; and in 2017, listed #275 in Forbes inaugural ranking of America's Top 500 Public Companies. Headquartered in King of Prussia, PA, UHS has more than 87,000 employees and through its subsidiaries operates 26 acute care hospitals, 327 behavioral health facilities, 40 outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 37 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom.

Job Type: Part-time

Benefits:

  • Employee assistance program
  • Flexible schedule

Ability to Relocate:

  • Newark, DE 19713: Relocate before starting work (Required)

Work Location: In person

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