Methodist Family Health · 5 months ago
Utilization Review Tech (Part-time)
Maumelle, Arkansas, United States
Full-time, Part-time
Onsite
Entry Level
1+ years expMethodist Family Health is a healthcare organization seeking a Utilization Review Tech to manage client authorizations and assist with tracking departmental quality performance. The role involves preparing records, managing failed claims, and coordinating with other departments to ensure efficiency in service delivery.
Non ProfitHealthcareAssociationHealth Care
Responsibilities
Manages client’s authorizations (units/sessions) for services and submits requests for initial and additional authorizations and communicates authorization information and requirements to the appropriate clinical and/or administrative staff
Participates in and provides assistance with tracking data correlated with department quality performance
Prepares and maintains appropriate records and/or documents and submits reports as required
Provides assistance and coordination with other UR departments to maximize efficiency
Manages Failed Claims/Failed Activities and obtaining all insurance eligibilities daily
Completes UR Admissions/Discharges in the electronic medical record
Assists with preparing documentation for appeals and hearings as needed
Prepares and maintains appropriate records and/or documents and submits reports as required
Reviews and certifies patient stays and need for any length of stay extensions in accordance with commercial insurance and governmental agency standards – Inpatient Programs
Assists with obtaining initial Primary Care Physician Referrals as needed and obtains continuing Primary Care Physician Referrals – Inpatient and Sub-Acute Programs
Performs other related duties as assigned
Qualification
Required
Bachelor's Degree in Social Work or related field preferred; relevant work experience may be substituted for education
One-year admissions or UR experience, or related field; knowledge of length of stay guidelines is preferred
Good writing skills, computer skills, and experience with Microsoft applications
Must be physically capable to receive verbal and written directions
Must be willing and able to work with all patients of Methodist Family Health, regardless of gender
Must have good auditory, visual and olfactory ability
Must be able to maintain effective audio, visual discrimination and perception needed for making observations, communicating with others, reading and writing, and operating office equipment and other treatment equipment
Must be able to use a telephone to communicate verbally and a computer to communicate through written means, to review information and enter/retrieve data, to see and read characters on a computer screen, chart or other treatment items
Requires the strength and stamina to perform clinical duties
Flu shot is mandatory and required for all positions (subject only to qualified exemptions)
COVID-19 vaccination and Flu vaccination are mandatory and required for all positions (subject to qualified exemptions)
Preferred
Bachelor's Degree in Social Work or related field preferred; relevant work experience may be substituted for education
One-year admissions or UR experience, or related field; knowledge of length of stay guidelines is preferred
Company
Methodist Family Health
Methodist Family Health provides care for children with psychiatric, behavioral, emotional, and spiritual issues.
501-1000 employees
Funding
Current Stage
Late StageTotal Funding
$0.95M2021-02-05Grant· $0.95M
Leadership Team
A
Andy Altom
President/CEO
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