UTILIZATION REVIEW TECH - FT in Norristown, PA at SUBURBAN HOSPITAL

Date Posted: 10/5/2018

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    2701 Dekalb Pike
    Norristown, PA
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:
    10/5/2018

Job Description

The Utilization review tech essentially works to coordinate the utilization review and appeals process as part of the denial management initiatives. Utilization review tech is responsible for coordinating phone calls, data entry and tracking data from various insurance providers and health plans regarding authorization, expedited reviews and appeals. Document and track all communication attempts with insurance providers and health plans. Utilization review tech will follow up on all denials while working closely with the Corporate/Facility Utilization review teams, Business Office and Case Managers. The Utilization review tech will also serve as the primary contact and coordinate the work to maintain integrity of tracking government review audits (RAC, MAC, CERT, ADR, Pre/Post Probes, QIO/Medicaid) and other payer audits as assigned. The Utilization review tech will further support the department needs for Release of Information, discharge coordination or other duties as assigned.