Utilization Management Coordinator PRN

University of Texas Southwestern Medical Center; Dallas (TX); On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

PPO medical plan

Paid Time Off

Retirement Programs (TRS)

Paid Parental Leave

Wellness programs

Tuition Reimbursement

Public Service Loan Forgiveness (PSLF)

Job summary

UT Southwestern Medical Center is seeking an Utilization Management Coordinator to support insurance reviews and authorizations in a fast-paced hospital setting. This PRN role requires weekday availability between 7am and 7pm and emphasizes accuracy in Epic documentation and timely communication with payors.

Qualified candidates will have a High School Diploma and 5 years of hospital or insurance industry experience, with some college preferred.

Qualifications

• High School Diploma required.
• 5 years of hospital and/or insurance industry experience.
• Some college preferred.

Responsibilities

• Assists in faxing initial, concurrent or discharge reviews to insurance companies.
• Documents information submitted by phone or fax into Epic.
• Manages phone and fax lines and performs clerical duties to support Utilization Management.
• Obtains pending authorizations by contacting insurance companies.
• Responds to requests for clinical reviews within contractual time frames.
• Generates and submits EPIC reports for third party payers.
• Maintains productivity and quality metrics in compliance with regulations.
• Notifies payors of patient admission and updates Payor Communication in EPIC.
• Performs other duties as assigned.

Skills

5 years hospital/insurance experience

Education

High School Diploma

Job description

Utilization Management Coordinator

PRN - Must have weekday availability between 7am - 7pm

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!

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
• 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.