Utilization Management Coordinator

adventhealth; Daytona Beach (FL); On-site; USD 23,000 - 39,000; Full time

Job summary

AdventHealth in Daytona Beach, FL is seeking a dedicated Utilization Management Clerk to monitor payor communications and support the team with clerical duties in a fast-paced hospital setting. You will enter approvals/denials, track payor issues, and help ensure timely patient care while upholding safety and patient service standards.

This position offers hands-on experience in a mission-driven health system.

Qualifications

• Associate degree preferred; High School diploma required.
• Experience in health care, hospital setting, or patient finance services.
• Field of Study: social work.
• Knowledge of Utilization Management processes preferred.

Responsibilities

• Monitors and addresses electronic faxes and emails from payors and forwards to Utilization Management team members.
• Supports clerical and administrative activities of the Utilization Management team.
• Enters pertinent approval and denial information into the computer programs for review.
• Monitors the centralized phone line for telephonic authorization and denial information from payors.
• Manages mail, uploads letters from payors to patient encounters, and forwards correspondences.
• Tracks and trends payor issues and escalates to Utilization Management leadership when needed.
• Manages multiple clerical duties and assigned projects to support daily operations.

Skills

Microsoft Office

Communication skills

Multitasking

Patient care

Diversity awareness

Independent work

Utilization Management knowledge

Care Management workflows

Education

Associate degree

High School diploma

Job description

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

All the benefits and perks you need for you and your family:

• Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance
• Paid Time Off from Day One
• 403-B Retirement Plan
• 4 Weeks 100% Paid Parental Leave
• Career Development
• Whole Person Well-being Resources
• Mental Health Resources and Support
• Pet Benefits

Schedule:

Full time

Shift:

Day (United States of America)

Address:

301 MEMORIAL MEDICAL PKWY

City:

DAYTONA BEACH

State:

Florida

Postal Code:

32117

Job Description:

Monitors and addresses electronic faxes and emails from payors. Forwards communication to appropriate Utilization Management team members. Supports clerical and administrative activities of the Utilization Management team. Enters pertinent approval and denial information into the appropriate computer programs for Utilization Management team members to review and address in a timely manner. Monitors the Centralized Phone Line for telephonic authorization and denial information from payors. Manages and monitors mail from the department mailbox, including uploading letters from payors to patient encounters and forwarding correspondences to applicable departments. Tracks and trends payor issues and potential contractual issues, escalating to Utilization Management leadership. Manages multiple clerical duties and assigned projects, supporting daily operational flows and special projects as required. All other duties as assigned.

Knowledge, Skills, and Abilities:

• Understanding of Microsoft Office Products and other appropriate software platforms [Required]
• Ability to communicate effectively and professionally via phone and email [Required]
• Ability to manage multiple tasks and prioritize level of importance [Required]
• Ability to perform duties in a manner to promote quality patient care and customer service/satisfaction, while promoting safety and a commitment to AH principles [Required]
• Ability to work with people of all social, economic, and cultural backgrounds; be flexible, open-minded and adaptable to change [Required]
• Ability to work with minimal supervision [Required]
• Knowledge of Utilization Management processes [Preferred]
• Knowledge of Care Management processes/workflows [Preferred]

Education:

• Associate [Preferred]
• High School Grad or Equiv [Required]

Field of Study:

• social work

Work Experience:

• Experience in health care, hospital setting, and/or Patient Finance Services [Required]

Additional Information:

• N/A

Licenses and Certifications:

• N/A

Physical Requirements:

(Please click the link below to view work requirements)

Physical Requirements - https://tinyurl.com/23km2677

Pay Range:

$17.63 - $28.20

Background Screening Requirement (Florida Law)

Certain positions are subject Florida Level 2 background screening, including fingerprinting, as required by state law.

Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse: https://info.flclearinghouse.com/

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.