Company

Loyola University Health SystemSee more

addressAddressMaywood, IL
type Form of workFull-time
salary Salary$36.9K - $46.7K a year
CategoryEducation/Training

Job description

Employment Type:
Full time
Shift:
Description:
Utilization Review Assistant (URA)
The URA role is key to daily workflows in our Utilization Review Department. Daily responsibilities include timely denial processing, scheduling and data collection. Daily use of Epic WQ's, and processing faxes, approvals and requests for clinical. Strong organizational skills are a must in the fast-paced environment, team focused environment. This is a hybrid position.

Great opportunity for a Regional Utilization Review Assistantto work in an organization that focuses on treating the whole person, physically, emotionally and spiritually.

The Regional Utilization Review Assistant is an integral part of the Regional Utilization Review department. This role is an important link between insurance payers, Physician Advisors, Financial Clearance team and UR nurses as they monitor and manage denial/approval communication/clinical requests to ensure timely responses to payers, while mitigating the risk for insurance denials.
Daily workflows include Epic WQs cleared within department standards, obtaining authorizations, faxing payer clinical and confirming certified days from payers to finalize bed day authorizations and mitigate denials. Responsible for closing out final auth documentation in Allscripts. Other duties include accessing insurance payer portals to review denials/approvals within appropriate turnaround time to minimize the likelihood of payment denials. Timely notification to the appropriate team members to ensure follow through for clinical requests as needed. Schedules peer to peer with the payers and hospital physicians within designated timeframes.
Daily interaction with FCC (Financial Clearance Center) colleagues, physician advisors, UR Nurses and leadership to ensure correct patient insurance is identified and right payer receives timely clinical documentation for insurance payment. Updates demographics, correct payer contact information to complete all authorizations for hospital admissions. Frequent daily communication with physician advisors, Utilization Review nurses, manager and hospital colleagues regarding status of administrative denials for medical necessity, lack of clinical and level of care.

We offer our employees:

  • Benefits from Day One
  • Competitive compensation
  • Career Development
  • Tuition Reimbursement
  • On Site Fitness Center
  • Educational Stipend
  • Referral rewards

Our Promise to You:

Joining Loyola Medicine is being a part of an organization that treats the human spirit in our patients and in our colleagues. We are a part of a community which believes in giving back to those we serve.

We seek colleagues with:

Education:

Required: High School Diploma plus training acquired through work experience or education

Preferred: Associates Degree

Minimum Experience:

Required: 3-5 years of previous job-related experience. Excellent organizational and communication skills, knowledge of Excel and keyboarding. Typing skills are a must.

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.

Benefits

On-site gym, Tuition reimbursement, Gym membership, Benefits from day one
Refer code: 8713496. Loyola University Health System - The previous day - 2024-03-24 14:20

Loyola University Health System

Maywood, IL
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