Utilization Review Coordinator - Day Shift

This position is responsible to ensure all initial authorizations are initiated with appropriate payor, the required notes are documented, the authorization detail is set up in Case Management, and the information is subsequently verified in the payor websites where applicable. Other responsibilities include: retrieving discharge documents on a daily basis from charts, faxing when applicable, and retrieving authorizations.

KEY RESPONSIBILITIES:

Initial Authorizations - This task involves running the morning report and identifying all accounts where an authorization doesn’t exist and entering appropriate data to identify the department responsible for obtaining initial authorization.

Daily Discharges - Retrieve required documentation from the patient’s medical record for daily discharges and process according to payor requirements.

UR Metro Fax - On a daily basis monitor UR metro fax emails, label when completed, update case management when necessary, save and index as appropriate.

Accounts pending Discharge Diagnosis - Update on a daily basis the number of discharges per day and accounts pending discharge diagnosis.

Additional duties include, but are not limited to:

• Copy medical records for appeal;
• Review appeal letters for accuracy;
• Prepare postage, pack and mail appeal packets;
• Update Denial Tracker;
• Scan selected appeal documents and index

• High school diploma or GED required
• Two (2) years healthcare experience preferred
• Knowledge of Nevada Payors required
• Strong Microsoft word and excel skills required
• Maintains confidentiality of patients at all times

Eligible for benefits 1st of the month following 30-days of employment.

Desert Parkway offers competitive benefits to include:

• Health insurance
• Vision insurance
• Dental insurance
• 401K Retirement Plan
• Healthcare spending account
• Dependent care spending account
• PTO Plan with holiday premium pay
• Discounted cafeteria meal plan
• Life insurance (Supplemental Life, Term and Universal plans are also available)
• Short- and long-term disability (with additional buy-in opportunities)