PRN Utilization Mgmt. Coord

UT Southwestern Medical Center • Dallas, TX

69d

About The Position

The Utilization Management Coordinator works under the supervision of the Utilization Review Manager. This position requires 5 years of hospital and/or medical insurance industry experience. The coordinator must be available for PRN shifts from Monday to Sunday, 7:00 am to 6:00 pm. The role involves assisting in various tasks related to utilization management, including communication with insurance companies and documentation in the EPIC system.

Requirements

• 5 years of hospital and/or medical insurance industry experience required.
• High School Diploma required.
• EPIC experience strongly preferred.

Nice To Haves

• Some college preferred.

Responsibilities

• Assists in faxing initial, concurrent or discharge reviews to insurance companies.
• Documents information submitted/received by phone or fax from insurance companies into Epic.
• Manages phone and fax lines.
• Processes incoming faxes, scans documents and performs other clerical duties as necessary.
• Communicates with insurance companies to obtain pending authorizations.
• Responds to insurance requests for clinical reviews within designated time frames.
• Generates and submits EPIC reports specific to third party payers.
• Maintains departmental productivity and quality metrics.
• Completes assigned tasks in compliance with regulatory and departmental requirements.
• Calls payors to notify them of patient's admission and updates Payor Communication in EPIC.
• Monitors work queue to ensure timely notification of admission.
• Performs other duties as assigned.

Benefits

• PPO medical plan, available day one at no cost for full-time employee-only coverage.
• 100% coverage for preventive healthcare - no copay.
• Paid Time Off, available day one.
• Retirement Programs through the Teacher Retirement System of Texas (TRS).
• Paid Parental Leave Benefit.
• Wellness programs.
• Tuition Reimbursement.
• Public Service Loan Forgiveness (PSLF) Qualified Employer.

What This Job Offers

• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees