Utilization Management Coordinator PRN

UT Southwestern Medical Center • Dallas, TX

9d • Onsite

About The Position

The Utilization Management Coordinator PRN position at UT Southwestern is responsible for assisting with the faxing of initial, concurrent, or discharge reviews to insurance companies. This role involves documenting information submitted or received from insurance companies into Epic, managing phone and fax lines, and processing incoming faxes. The coordinator will also scan documents and perform other clerical duties to support Utilization Management functions. Key responsibilities include communicating with insurance companies to obtain pending authorizations, responding to requests for clinical reviews within designated time frames, and generating/submitting Epic reports specific to third-party payers. The position requires maintaining departmental productivity and quality metrics, ensuring compliance with regulatory and departmental requirements, and notifying payors of patient admissions while updating Payor Communication in Epic. This role is security-sensitive and subject to criminal history record information checks.

Requirements

• High School Diploma
• 5 years of hospital and/or insurance industry experience.

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 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.
• 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%25 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: Mid Level
• Education Level: High school or GED