Community Health Systems, Inc. is one of the nation’s leading operators of general acute care hospitals. The organization’s affiliates own, operate or lease 89 hospitals in 16 states with approximately 15,000 licensed beds. Affiliated hospitals are dedicated to providing quality healthcare for local residents and contribute to the economic development of their communities. Based on the unique needs of each community served, these hospitals offer a wide range of diagnostic, medical and surgical services in inpatient and outpatient settings.
CHSPSC, LLC seeks a Utilization Review Coordinator for its headquarters’ Case Management team.
Summary:
This role serves as a payor liaison to ensures that an authorization for services is obtained from payor, if required and communication with commercial payers is completed in a timely manner and is available to the Utilization Review Clinical Specialist for administrative, payor related tasks.
Essential Duties and Responsbilities:
Qualifications:
Required Education: High School Diploma
Preferred Education: Bachelor's Degree
Required Experience: At least 2 years related experience and/or training
Preferred Experience: 3 plus years Utilization review experience
Required License/Registration/Certification: N/A
Preferred License/Registration/Certification: N/A
Computer Skills Required: Data entry skills; Demonstrable skills with Google Docs, Google Sheets, Microsoft Word, Microsoft Excel software and email applications.
Language Ability Ability to read and comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.
Math Ability Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.
Reasoning Ability Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions. Ability to deal with problems involving a few concrete variables in standardized situations.
Physicial Demands:
In order to successfully perform this job, with or without a reasonable accommodation, the following are outlined below:
1. The Employee is required to read, review, prepare and analyze written data and figures, using a PC or similar, and should possess visual acuity.
2. The Employee may be required to occasionally climb, push, stand, walk, reach, grasp, kneel, stoop, and/or perform repetitive motions.
3. The Employee is not substantially exposed to adverse environmental conditions and; therefore, job functions are typically performed under conditions such as those found within general office or administrative work.
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