Utilization Coordinator- Full Time - Riverside, United States - Riverside Medical Clinic

Riverside Medical Clinic

Verified Company

Riverside, United States

3 weeks ago

Posted by:

Mark Lane

beBee recruiter

Full time

Description

Responsibilities:

Come and join the RMC Family
We have been in the community since 1935. Our mission is to provide comprehensive multi-specialty medical services in the greater Riverside region. Your passion, inspiration, and talents are invaluable to us and our mission to serve others. Our facility can provide a place for you to thrive and continue your professional development. Quality Healthcare is our passion, improving lives is our reward. We are working to change lives and transform the delivery of healthcare.

Riverside Medical Clinic is the best place to work, practice medicine, and receive care.

SUMMARY:
Verifies eligibility and benefits for patient services. Provides data entry and hard copy authorization for referrals.

QUALIFICATIONS:
To perform this job successfully, an individual must be able to perform each essential function satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

HOURS:
Monday-Friday 8:30am-5:30pm

Qualifications:

Essential Job Duties
Responsible for the collection of accurate data from utilization of services within the Utilization management Department. Prepare useful utilization statistics from this data.

Prepare monthly reports and analyze miscellaneous utilization data (i.e. percentage of C-sections, mental health utilization, home health/ DME utilization, and number of cardiac/ CABG cases, etc).

Develop and implement monthly utilization statistics, as necessary, for use in Utilization Management Department and Utilization Management Committee.

Prepare authorizations and fax, as necessary, to applicable providers, offices, or health plans.

Maintain an accurate tracking of all patients and the specific duties they are assigned and required to complete each month.

Verify patient benefits and eligibility prior to authorizing services or supplies.

Update insurance records as necessary.

Communicate system malfunctions and required benefit file updates, as necessary, to ensure system accuracy.

Update authorizations on system to ensure timely turnaround and compliance with health plan requirements.

QUALIFICATIONS:
To perform this job successfully, an individual must be able to perform each essential function satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EDUCATION and/or EXPERIENCE:
High school diploma or GED required. One to three months related experience and/or training; or equivalent combination of education and experience.

This opportunity offers the following:

Challenging and rewarding work environment

Growth and Development Opportunities within UHS and its Subsidiaries

Competitive Compensation

One of the nation's largest and most respected hospital companies, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Steadily growing from a startup to an esteemed Fortune 500 corporation, UHS today has annual revenue nearing $10 billion.

In 2017, UHS was recognized as one of the World's Most Admired Companies by Fortune; ranked #276 on the Fortune 500, and listed #275 in Forbes inaugural ranking of America's Top 500 Public Companies.

Our operating philosophy is as effective today as it was 40 years ago: Build or acquire high quality hospitals in rapidly growing markets, invest in the people and equipment needed to allow each facility to thrive, and become the leading healthcare provider in each community we serve.

Headquartered in King of Prussia, PA, UHS has more than 81,000 employees and through its subsidiaries operates more than 320 acute care hospitals, behavioral health facilities and ambulatory centers in the United States, Puerto Rico, the U.S.

Virgin Islands and the United Kingdom.

UHS is a registered trademark of UHS of Delaware, Inc., the management company for Universal Health Services, Inc. and a whollyowned subsidiary of Universal Health Services, Inc. Universal Health Services, Inc. is a holding company and operates through its subsidiaries including its management company, UHS of Delaware, Inc. All healthcare and management operations are conducted by subsidiaries of Universal Health Services, Inc. To the extent any reference to "UHS or UHS facilities" on this website including any statements, articles or other publications contained herein relates to our healthcare or management operations it is referring to Universal Health Services' subsidiaries including UHS of Delaware. Further, the terms "we," "us," "our" or "the company" in such context similarly refer to the operations of Universal Health Services' subsidiaries including UHS of Delaware. Any employment referenced in this website is not with Univ