Coordinator, Resource Management

3 weeks ago


Brunswick, United States Southeast Georgia Health System Full time

Interested in working for the Golden Isles’ healthcare provider and employer of choice?

Throughout the many locations that make up the Southeast Georgia Health System network, there is a common thread that pulls everything together: A team of committed professionals like you. These individuals appreciate the value of every person who walks through our doors, and are the key to our culture of Service Excellence.

As a Resource Management Coordinator, you will conduct medical record reviews of all denied inpatient and/or observation encounters. You will function as an administrative assistant as needed by the department Manager and/or Director. For our team members, this is more than a career — it’s a calling.

You will be responsible for:

  • Coordinates concurrent and retro precertification processes.
  • Assesses payer denials for appropriateness of appeal and initiates the appeal process in a timely manner. Demonstrates proficiency in preparation and follow-up of denial appeals. Maintains denial spreadsheet report-keeps it current & accurate by payer. Works congenially with Patient Financial Services department to ensure open & thorough communication.
  • Maintains ongoing knowledge of payer compliance issues and has the ability to convey same to physicians/office staff.
  • Assists the Manager with validating that utilization review processes are conducted as outlined in the Utilization Plan.
  • Coordinates patient’s appeals to the Quality Improvement Organization (QIO) ensuring timely medical record submission and tracking of QIO decision.
  • Responsible for data compilation regarding length-of-stay, avoidable days and readmissions, and the preparation of appropriate statistical information for dissemination to physicians, Quality Management, Health Information Management and Administration.
  • Serves as point of contact for all alternate language/communication needs within Health System – assists with accessing services as needed; maintains records of LEP equipment location.
  • Maintains time & attendance and PTO requests as approved by department Manager; Assists Case Managers in obtaining DME; Scans paper documentation into patient’s electronic medical record as needed. Other responsibilities as assigned.


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