UT Southwestern Medical Center
Utilization Management Coordinator PRN-Coverage 7 days/week as needed - DAY SHIF
UT Southwestern Medical Center, Dallas, Texas, United States, 75215
Utilization Management Coordinator PRN Days – Coverage 7 days per week as neededWhy 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 #1 hospital in Dallas-Fort Worth for the sixth consecutive year, we invite you to continue your healthcare career with us at William P. Clements Jr. University Hospital. You’ll discover a culture of teamwork, professionalism, and consistent opportunities for learning and advancement into leadership roles.
Performs EPIC functions to assist the UM department with payor communications. Assist in faxing documents to insurance companies. Manages phones and fax lines. Generates EPIC reports specific to third party payors. Assist with insurance company notification of admission process.
Experience and Education
High school graduate is required. Some college preferred.
5 years of hospital and/or insurance industry experience is required.
Knowledge of Health Insurance mechanisms and coverage is required.
Proficient in Microsoft Office Suite Working knowledge of EPIC is 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.
Performs other duties as assigned.
Knowledge, Skills, & Abilities
Knowledge of health insurance mechanisms and coverage
Knowledge of UR process including admission status and continued stay reviews
Proficient in Microsoft Office Suite, including Word, Excel, PowerPoint and Power BI
Strong oral and written communication skills
Demonstrated accuracy skills
Working ConditionsThis job is remote only and individuals who reside in the job will permanently work 100% from an alternate approved worksite. Any qualifications to be considered as equivalents in lieu of stated minimums require prior approval of the Vice President for Human Resources Administration, or his/her designee.
To learn more about the benefits UT Southwestern offers, visit https://www.utsouthwestern.edu/employees/hr-resources/
This position is security-sensitive and subject to Texas Education Code §51.215, which authorizes UT Southwestern to obtain criminal history record information.
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.Benefits
UT Southwestern is proud to offer a competitive and comprehensive benefits package to eligible employees. Our benefits are designed to support your overall wellbeing, and include:
PPO medical plan, available day one at no cost for full-time employee-only coverage100% coverage for preventive healthcare – no copayPaid Time Off, available day oneRetirement Programs through the Teacher Retirement System of Texas (TRS)Paid Parental Leave BenefitWellness programsTuition ReimbursementPublic Service Loan Forgiveness (PSLF) Qualified EmployerLearn more about these and other UTSW employee benefits!
Performs EPIC functions to assist the UM department with payor communications. Assist in faxing documents to insurance companies. Manages phones and fax lines. Generates EPIC reports specific to third party payors. Assist with insurance company notification of admission process.
Experience and Education
High school graduate is required. Some college preferred.
5 years of hospital and/or insurance industry experience is required.
Knowledge of Health Insurance mechanisms and coverage is required.
Proficient in Microsoft Office Suite Working knowledge of EPIC is 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.
Performs other duties as assigned.
Knowledge, Skills, & Abilities
Knowledge of health insurance mechanisms and coverage
Knowledge of UR process including admission status and continued stay reviews
Proficient in Microsoft Office Suite, including Word, Excel, PowerPoint and Power BI
Strong oral and written communication skills
Demonstrated accuracy skills
Working ConditionsThis job is remote only and individuals who reside in the job will permanently work 100% from an alternate approved worksite. Any qualifications to be considered as equivalents in lieu of stated minimums require prior approval of the Vice President for Human Resources Administration, or his/her designee.
To learn more about the benefits UT Southwestern offers, visit https://www.utsouthwestern.edu/employees/hr-resources/
This position is security-sensitive and subject to Texas Education Code §51.215, which authorizes UT Southwestern to obtain criminal history record information.
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.Benefits
UT Southwestern is proud to offer a competitive and comprehensive benefits package to eligible employees. Our benefits are designed to support your overall wellbeing, and include:
PPO medical plan, available day one at no cost for full-time employee-only coverage100% coverage for preventive healthcare – no copayPaid Time Off, available day oneRetirement Programs through the Teacher Retirement System of Texas (TRS)Paid Parental Leave BenefitWellness programsTuition ReimbursementPublic Service Loan Forgiveness (PSLF) Qualified EmployerLearn more about these and other UTSW employee benefits!