Per Diem-Admitting Worker PRN-Utilization review-Los Alamitos-Days

University of California, Irvine•Los Alamitos, CA

2d•Onsite

About The Position

The Admitting Worker PRN position is responsible for following up on patient accounts when authorization for stay is required. This role involves faxing clinical reviews, monitoring each account during the stay and upon discharge for authorization, and documenting all actions in the electronic system. The individual will escalate potential disputes or denial of accounts to the Director of Case Management or designee, trend disputed claims by payor and physician, and assist in obtaining authorization for patients discharged to Skilled Facilities or other post-acute care requiring authorization. Other duties as assigned.

Requirements

Must possess the skill, knowledge and ability essential to the successful performance of assigned duties.
Must demonstrate customer service skills appropriate to the job.
Excellent written and verbal communication skills in English.
Ability to maintain a work pace appropriate to the workload.
Ability to establish and maintain effective working relationships across the Health System.
High school diploma or equivalent required.
Excellent organizational skills.
Excellent verbal and written communication skills.
Demonstrated problem solving skills.
Computer literacy.
Must be able to provide proof of work authorization.

Nice To Haves

Knowledge of University and Medical Center organizations, policies, procedures and forms.
Associate or Bachelor's degree preferred.
Paramedic, EMT or Nursing Assistant certification preferred.
Acute hospital experience preferred.
Data Analytic skills preferred.

Responsibilities

Follow up on patient accounts when authorization for stay is required.
Fax clinical reviews.
Follow up on each account during the stay and on discharge for authorization and document in the electronic system.
Escalate any potential disputes or denial of accounts to Director of Case Management or designee.
Trend disputed claims by payor and physician.
Assist in obtaining authorization for patient discharged to Skilled Facilities or other post-acute care that require authorization.
Perform other duties as assigned.