- Initial authorizations of outpatient physical therapy services: Reviews and authorizes services that meet criteria, along with supporting documentation. It is the responsibility of the URC to ensure outpatient physical therapy services are provided at the appropriate level and are received per the defined plan guidelines.
- Re-authorization/concurrent review for continued therapy: Reviews clinic documentation submitted by the provider to ensure services continue to meet defined plan guidelines.
- Care Management: Reviews all cases meeting criteria to determine if the member qualifies for TPTNs internal Care Management program. Will facilitate all Care Management related communications being sent to the member.
- Investigate and resolve questions related to authorization and claims activity.
- Assists in maintaining department compliance with state, federal, HIPAA and DOL regulations.
- Assists in resolving issues relative to clinical procedures.
- Participates in monthly Health Services Meetings.
- Potential for limited local travel to attend Client Health Fairs.
- Two to five years of experience, preferably in a managed care environment
- Working knowledge of the physical therapy industry is a definite plus.
- Strong written and verbal communication skills.
- Strong customer service skills/experience.
- Strong computer skills a must (Word, Excel, etc.).
- Independent, self-starter who is results and goal oriented.
-
Utilization Review Coordinator
4 weeks ago
TheraMatrix Pontiac, United StatesJob Description · Job DescriptionDuties and Responsibilities: · Initial authorizations of outpatient physical therapy services: Reviews and authorizes services that meet criteria, along with supporting documentation. It is the responsibility of the URC to ensure outpatient physi ...
-
Utilization Review Coordinator
4 weeks ago
Theramatrix Physical Therapy Network, Inc Pontiac, United StatesJob Description · Duties and Responsibilities: · Initial authorizations of outpatient physical therapy services: Reviews and authorizes services that meet criteria, along with supporting documentation. It is the responsibility of the URC to ensure outpatient physical therapy serv ...
-
Henry Ford Health System Troy, United States Full timeLocation - Remote · Hours are 8 hour shifts, with hours of operation from 7:30am until 6:30pm, No holidays and working Monday through Friday with a rotating weekend schedule of every 5th weekend. · Under minimal supervision, reviews and screens the appropriateness of services, th ...
-
Henry Ford Hospital Troy, United States Full timeLocation - Remote · Hours are 8 hour shifts, with hours of operation from 7:30am until 6:30pm, No holidays and working Monday through Friday with a rotating weekend schedule of every 5th weekend. · Under minimal supervision, reviews and screens the appropriateness of services, th ...
-
Henry Ford Hospital Wyandotte, United States Full timeGeneral Summary: · With guidance and direction from the Senior Level Leadership, in collaboration with the Medical Staff Leadership Team, the Clinical Peer Review Coordinator is a registered nurse who performs project work of a complex nature with interdisciplinary groups that in ...
-
Henry Ford Health System Wyandotte, United States Full timeGeneral Summary: · With guidance and direction from the Senior Level Leadership, in collaboration with the Medical Staff Leadership Team, the Clinical Peer Review Coordinator is a registered nurse who performs project work of a complex nature with interdisciplinary groups that i ...
-
Executive Chef
2 weeks ago
Trinity Health Pontiac, United StatesEmployment Type: · Full timeShift: · Description: · POSITION PURPOSE · Under the general direction of the General Manager, Food & Nutrition Services, the Executive Chef is responsible for the oversight and day-to-day culinary operations of the Regional Health Ministry's (RHM) ...
-
Engineering Summer Paid Intern
2 weeks ago
Advanced Technology Services Pontiac, United StatesFounded in 1985, ATS is a company with a presence in the United States, Mexico and the United Kingdom. We are professionals in Industrial Maintenance and we make factories run better. · Fundada en 1985, ATS es una empresa con presencia en los Estados Unidos, México y el Reino Uni ...
-
McLaren Health Care Pontiac, MI, United StatesPosition Summary: · The trauma PI specialist supports the Trauma program's Performance Improvement and Patient Safety (PIPS) activities, including reviewing of trauma care across the continuum of care, case finding, and audit of medical records. Provides coordination and facilita ...
-
Criminal Justice/Casework Assistant
2 weeks ago
Oakland County (MI) Pontiac, United StatesAnnouncement Information · Part-Time Non-Eligible summer employee positions are not part of the Oakland County Merit System. These positions are limited to 520 hours during the summer months. This position will be working from Mid April 2024 to Mid September 2024. · TRANSCRIPTS R ...
-
Hospital Supervisor
2 weeks ago
DMC Harper University/Hutzel Women's Hospital Pontiac, MI, United States Full timeDMC Harper University Hospital has distinguished itself in surgery and medicine and is known for its clinical expertise and innovative research. A specialty referral hospital, Harper has established Centers of Excellence in neurosciences, bariatric surgery, vascular services, mu ...
-
arpa project manager
2 weeks ago
City of Pontiac Pontiac, United StatesJob Description · Job DescriptionJOB DESCRIPTION · ARPA Project Manager · Salary - $80, $100,000.00 · FLSA Status: Exempt · SUPERVISION · Supervision Received: Reports the Mayor · Supervision Given: May supervise staff · Note: This is not a long-term position as it will not conti ...
-
city engineer
2 weeks ago
City of Pontiac Pontiac, United StatesJob Description · Job DescriptionCity Engineer · FLSA: Administrative exemption · Summary: An incumbent in this position is responsible for performing professional civil engineering and responsible administrative work in the designing, planning, and inspecting municipal constru ...
-
arpa funds manager
2 weeks ago
City of Pontiac Pontiac, United StatesJob Description · Job DescriptionJOB DESCRIPTION · ARPA Funds Manager · Salary - $80, $100,000.00 · FLSA Status: Exempt · SUPERVISION · Supervision Received: Reports the Mayor · Supervision Given: May supervise staff · Note: This is not a long-term position as it will not continu ...
-
Financial Coordinator
11 hours ago
BluePearl Pontiac, United States**BluePearl Pet Hospital** **in Auburn Hills, MN** **is** **seeking** **an organized, fiscally responsible, and goal-driven Financial Coordinator to join our team.** · As the Financial Coordinator, you will have primary responsibility for charge capture and other billing-related ...
-
Health Officer
4 weeks ago
Oakland County (MI) Pontiac, United StatesAnnouncement Information · Oakland County is hiring a Health Officer · What's the Role? · The Health Officer will be responsible for planning, developing, and implementing a comprehensive County-Wide public health program. Responsibilities include promoting health programs, legis ...
-
Shipping & Receiving Clerk
4 weeks ago
Allegiance Staffing Pontiac, United StatesJob Description · Job DescriptionGENERAL SUMMARY: Receive inbound/outbound conveyances within the MGO system recording, finalizing, and ensuring inventory integrity of material within the four walls of the company. ESSENTIAL JOB FUNCTIONS: Review all incoming documentation cov ...
-
2S ICU HUC Part time Nightshift
3 weeks ago
Trinity Health Corporation Pontiac, MI, United States Part timeEmployment Type: · Part time · Shift: · 12 Hour Night Shift · Description: · Accountability Objectives: · Coordinates activities which relate to the flow of unit and patient information. This includes but is not limited to: phone management, maintenance of patient charts, orderin ...
-
General Supervisor Maintenance
3 days ago
The Doe Run Company Boss, United StatesWe are Doe Run - producing metals and recycling batteries for a clean energy future. · Based in St. Louis, Missouri, The Doe Run Company is a privately held natural resources company and one of the largest lead producers in the Western Hemisphere. Dedicated to environmentally res ...
-
2S ICU HUC Part time Nightshift
5 hours ago
Trinity Health Pontiac, United States Part time**Employment Type:** · Part time · **Shift:** · 12 Hour Night Shift · **Description:** · **Accountability Objectives:** · Coordinates activities which relate to the flow of unit and patient information. This includes but is not limited to: phone management, maintenance of patient ...
Utilization Review Coordinator - Pontiac, United States - Theramatrix Physical Therapy Network Inc
![Default job background](https://contents.bebee.com/public/img/bg-user-ex-1.jpg)
Description
Job DescriptionDuties and Responsibilities:
Healthcare professional with an acquired background in physical therapy. Must possess an Associate's Degree, Bachelors degree preferred. Experience in lieu of a degree will be considered.
Company Description
Exceptional Customer Service starts with having team members who understand and embody collaboration and team work. It continues every day with a positive, problem-solving approach to any issues or concerns - regardless of how small and with continued expression of appreciation for our team.
What we do is so important. Interested in joining us in that mission?
Exceptional Customer Service starts with having team members who understand and embody collaboration and team work. It continues every day with a positive, problem-solving approach to any issues or concerns - regardless of how small and with continued expression of appreciation for our team. What we do is so important. Interested in joining us in that mission?