UR COORDINATOR- Full Time

UHS • Riverside, CA

76d

About The Position

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.

Requirements

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

Responsibilities

• Responsible for the collection of accurate data from utilization of services within the Utilization Review 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 Review 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.

Benefits

• Challenging and rewarding work environment
• Growth and Development Opportunities within UHS and its Subsidiaries
• Competitive Compensation

What This Job Offers

• Education Level: High school or GED
• Number of Employees: 1,001-5,000 employees