1+ months

Utilization Review Coordinator (UR Coordinator) - (115750)

Universal Health Services
Seattle, WA 98104
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  • Job Code
    115750

Schick Shadel Hospital is seeking a Utilization Review Coordinator (UR Coordinator) to help oversee and perform the process of utilization review to ensure appropriate reimbursement by third party payers. This includes managing the denial/appeals process, as well as the flow, organization, and reporting of information.

Schick Shadel Hospital, a subsidiary of UHS, is a60 bed alcohol andsubstance use disorder hospital located in the outskirts of Seattle, has been providing successful chemical dependency treatment since 1935.The Hospital, which claims the "#1 Success Rate" in treating alcoholism, bases its success on its unique and powerful counter conditioning treatment program. The Hospital provides medication detoxification and an intense, short stay addiction treatment program for alcohol, marijuana, cocaine, methamphetamine, prescription opioids and heroin (smoked or snorted).

Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Steadily growing from a startup to an esteemed Fortune 500 corporation, UHS today has annual revenue nearing $10 billion. In 2017, UHS was recognized as one of the Worlds Most Admired Companies by Fortune; ranked #276 on the Fortune 500, and listed #275 in Forbes inaugural ranking of Americas Top 500 Public Companies.

Our operating philosophy is as effective today as it was 40 years ago: Build or acquire high quality hospitals in rapidly growing markets, invest in the people and equipment needed to allow each facility to thrive, and become the leading healthcare provider in each community we serve.

Headquartered in King of Prussia, PA, UHS has more than 81,000 employees and through its subsidiaries operates more than 320 acute care hospitals, behavioral health facilities and ambulatory centers in the United States, Puerto Rico, the U.S. Virgin Islands and the United Kingdom.

Job Requirements

The specific duties of the Utilization Review Coordinator include but are not limited to:

1. Obtaining preauthorization for admissions and continued stays according to third party guidelines within one business day of admission (unless otherwise required), including researching and obtaining any necessary insurance contact information, and coordinating scheduled meetings between hospital and insurance doctors.
2. Managing and performing the processes for retrospective authorizations and denials/appeals.
3. Timely communicating preauthorization outcomes, follow-up instructions, options, and related information to relevant hospital staff and patients. This includes responding to all calls and emails within one business day unless otherwise required.
4. Documenting activity in Billing and UR software, and preparing reports for meetings and management review.
5. Organizing and filing documents for ease of access in approved locations.
6. Assisting in compiling information for data analysis relating to preauthorization and reimbursement.
7. Providing assistance to hospital staff in determining the likelihood of insurances covering treatment.
8. Maintaining patient confidentiality in accordance with state and federal law.
9. Participating in hospital information meetings, required in-service education and training, and hospital-wide performance improvement and compliance activities.
10. Promote and incorporate service excellence standards into job responsibilities and interactions. This includes incorporating service recovery skills into difficult patient discussions, and respecting the rights of patients and staff not to participate in or listen to conversations where frustrations and grievances are expressed in an unproductive manner.

OTHER SKILLS, ABILITIES AND REQUIREMENTS:

1. Extensive knowledge of behavioral health systems and Utilization Management required.
2. Two years of UR experience in a hospital or healthcare insurance setting required.
3. MSW, BSN, RN, CDP, or LICSW license in good standing preferred.

Posted: 2019-12-13 Expires: 2020-02-16

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Utilization Review Coordinator (UR Coordinator) - (115750)

Universal Health Services
Seattle, WA 98104

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