Company:
Sheppard Pratt
Location: Towson
Closing Date: 23/10/2024
Hours: Full Time
Type: Permanent
Job Requirements / Description
As a Utilization Review Coordinator you will:
- Review and assesse appropriateness of patient admission/continued stay
- Work with Financial Case Management Representatives to monitor use of insurance benefits to maximize service to patients
- Provide timely, pertinent insurance benefits information to clinical staff so that they will provide care within patients' benefits package and thereby optimize third party payment for services
- Assist physicians in preparing appeals when payment has been denied by insurance companies
- Assist in the implementation of the Hospital Utilization Review Plan
- Provide consultation and/or education to clinical staff regarding monitoring studies and medical records reviews
- Represents hospital in involuntary hearings process
- Serves as a member of various clinical committees and provides staff support to committee chairpersons
- Bachelor's degree from an accredited institution in nursing, allied health, records administration, or closely related field
- 2 years of related experience - Comprehensive knowledge of patient medical records, health insurance provisions, psychiatric diagnoses, and utilization review practices
- Strong interpersonal and analytical skills
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Sheppard Pratt