Utilization Mgmt Coord/PRN

University of Texas Southwestern Medical Center • Dallas, TX

33d

About The Position

Utilization Management Coordinator - PRN 5 years of hospital and/or medical insurance industry experience required EPIC experience strongly preferred Must be available for PRN shifts Monday - Sunday 7:00am-6:00pm WHY UT SOUTHWESTERN? With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and research center, we strive to provide the best possible care, resources, and benefits for our valued employees. Ranked as the number 1 hospital in Dallas-Fort Worth according to U.S. News & World Report, we invest in you with opportunities for career growth and development to align with your future goals. Our highly competitive benefits package offers healthcare, PTO and paid holidays, on-site childcare, wage, merit increases and so much more. We invite you to be a part of the UT Southwestern team where you'll discover a culture of teamwork, professionalism, and a rewarding career! JOB SUMMARY Works under supervision of the Utilization Review Manager. BENEFITS UT Southwestern is proud to offer a competitive and comprehensive benefits package to eligible employees. Our benefits are designed to support your overall wellbeing, and include: 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 Learn more about these and other UTSW employee benefits! EXPERIENCE AND EDUCATION Required Education High School Diploma Experience 5 years of hospital and/or insurance industry experience. Preferred Education Some college preferred. JOB DUTIES 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 other clerical duties as deemed necessary to assist with the facilitation of Utilization Management functions. Communicates with insurance company to obtain pending authorizations. Responds to insurance requests for clinical reviews within time frames designated by contractual obligations. Generates and submits EPIC reports specific to third party payers. Maintains departmental productivity, quality metrics and completes assigned tasks in compliance with regulatory and departmental requirements. Assists in faxing initial, concurrent or discharge reviews to insurance companies. Calls payors to notify them of patient's admission, updates Payor Communication in EPIC, monitors work queue to ensure timely notification of admission. Performs other duties as assigned. SECURITY AND EEO STATEMENT Security This position is security-sensitive and subject to Texas Education Code 51.215, which authorizes UT Southwestern to obtain criminal history record information. EEO UT Southwestern Medical Center is committed to an educational and working environment that provides equal opportunity to all members of the University community. As an equal opportunity employer, UT Southwestern prohibits unlawful discrimination, including discrimination on the basis of race, color, religion, national origin, sex, sexual orientation, gender identity, gender expression, age, disability, genetic information, citizenship status, or veteran status.

Requirements

• High School Diploma
• 5 years of hospital and/or insurance industry experience.
• Must be available for PRN shifts Monday - Sunday 7:00am-6:00pm

Nice To Haves

• Some college preferred.
• EPIC experience strongly 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 other clerical duties as deemed necessary to assist with the facilitation of Utilization Management functions.
• Communicates with insurance company to obtain pending authorizations.
• Responds to insurance requests for clinical reviews within time frames designated by contractual obligations.
• Generates and submits EPIC reports specific to third party payers.
• Maintains departmental productivity, quality metrics and completes assigned tasks in compliance with regulatory and departmental requirements.
• Assists in faxing initial, concurrent or discharge reviews to insurance companies.
• Calls payors to notify them of patient's admission, 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

• Job Type: Part-time
• Industry: Educational Services
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees