Under the direction of the Care Coordination Department Leadership, the UR Coordinator directs all back-office functions of the Utilization Review Department. Interfaces with all payors/providers requesting authorizations, medical records, and other specific information. Confirms completeness of reviews to payors. Directs concurrent denials to appropriate local staff.
This is an on-site position. Monday-Friday 8:00am-4:30pm
What you will do:- Interfaces with all payors and providers requesting authorizations, medical records, and other specific information.
- Diligently manages all clinical review work queues assigned to Utilization Management.
- Coordinates Physician Advisor referrals with there are concerns regarding meeting level of care criteria (utilizing Indicia/InterQual). Reviews PA referrals with department manager as needed.
- Reports an uncovered or at-risk days to leadership of Utilization Review.
- Promotes teamwork by working effectively as a team member as well as independently. Communicates & collaborates with multiple team members, including Utilization Management RNs, care managers, nursing unit staff, unit secretaries, insurance representatives, & others as needed.
- Ensures seamless communication with payers. Retrieves voicemails & faxes for the department & transcribes the information into the electronic medical record. Communicates in a positive, professional manner at all times.
- Performs basic reception functions to ensure smooth office operations, including answering incoming calls, maintaining an accurate filing system, ensuring office supplies stocked to appropriate levels and office equipment serviced, copying forms and documents, etc.
- Other duties as assigned.
Minimum Qualifications:
*2-3 years of Medical Office admin, customer service or related roles such as
Insurance authorizations, denials management etc.
Minimum Education:
*Tech/Trade Certificate
*High School Diploma
Position Highlights and Benefits
- Comprehensive benefit packages available, including medical, dental, vision, paid time off, 403B, and education assistance.
- We serve together in the spirit of the Gospel as a compassionate and transforming healing presence within our communities.
- We live and breathe our guiding behaviors: we support each other in serving, we communicate openly, honestly, respectfully, and directly, we are fully present, we are all accountable, we trust and assume goodness in intentions, and we are continuous learners.
Ministry/Facility Information:
- Holy Cross Hospital in Fort Lauderdale, Florida is a full-service, non-profit Catholic hospital, sponsored by the Sisters of Mercy and a member of Trinity Health.
- We are committed to providing compassionate and holistic person-centered care.
- We are the only Catholic hospital in Broward and Palm Beach counties and are not for profit. We are part of Trinity Health, one of the largest multi-institutional Catholic health care delivery systems in the nation. Together, we serve people and communities in 21 states from coast to coast, providing nearly 2.8 million visits annually.
- Comprehensive benefits that start on your first day of work
- Retirement savings program with employer matching
Legal Info
We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.
Our Commitment to Diversity and Inclusion
Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.
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What We Do
Trinity Health is one of the largest not-for-profit, Catholic health care systems in the nation. It is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians caring for diverse communities across 25 states. Nationally recognized for care and experience, the Trinity Health system includes 88 hospitals, 131 continuing care locations, the second largest PACE program in the country, 125 urgent care locations and many other health and well-being services. Based in Livonia, Michigan, its annual operating revenue is $20.2 billion with $1.2 billion returned to its communities in the form of charity care and other community benefit programs.
