Utilization Review Clerk
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Job Location:
Avondale, AZ - USA
Monthly Salary:
Not Disclosed
Posted on:
2 days ago
Vacancies:
1 Vacancy
Job Summary
Your experience matters
Copper Springs is part of Lifepoint Health a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As a Utilization Review Clerk joining our team youre embracing a vital mission dedicated to making communities healthier . Join us on this meaningful journey where your skills compassion and dedication will make a remarkable difference in the lives of those we serve.
How youll contribute
A Utilization Review Clerk who excels in this role:
- Obtains prior authorizations and ensures all medical services procedures and medications meet insurance requirements prior to delivery.
- Serves as a key liaison between Clinical Intake and UR Specialists to help prevent coverage gaps.
Core Responsibilities
Complete Precerts for IP & OP/Secure Authorizations:
Initiate and secure pre-authorizations for inpatient and outpatient services through insurance portals phone or fax.
Insurance Verification:
Confirm patient eligibility benefits and coverage limits with the business office before precerting. Communicate all updates or status changes directly to the UR Specialist and document that information in the EHR.
Documentation & EHR Management:
- Update Meditech with approval numbers status updates and denied dates of service.
- Upload and attach authorization approvals or denials to OnBase MR & scan completed packets to UR the Share drive.
- Complete prior authorization request documentation for major payers including
Banner Health Choice Molina Allwell Wellcare and Cigna.
Record Keeping:
- Maintain detailed insurance logs and ensure all patient chart documentation in Meditech
remains current.
Departmental Support:
- The UR Manager may assign other UR related task to be completed as needed.
What were looking for
Education:
- High school diploma required. Two years of experience in a behavioral health setting may substitute for an associate or bachelors degree. An associate or bachelors degree in a health-related field is preferred.
Experience:
- Background in a medical setting with experience in insurance coordination verification medical terminology case manager discharge coordinator or behavioral health setting.
Technical Skills:
- Proficiency with EMR systems (Meditech or Medik) Microsoft Office applications (Excel Outlook) and insurance portals such as Availity AZ Complete and Optum Star.
Abilities:
- Ability to manage high-volume cases in a high stress environment by completing time sensitive requests and effectively resolve authorization denials.
Schedule: Monday Friday
Why join us
We believe that investing in our employees is the first step to providing excellent patient addition to your base compensation this position also offers:
Comprehensive Benefits:Multiple levels of medical dental and vision coverage for full-time andpart-time employees.
Financial Protection & PTO:Life accident critical illness hospital indemnity insurance short- and long-term disability paid family leave and paid time off.
Financial & Career Growth:Higher education and certification tuition assistance loan assistance and 401(k) retirement package and company match.
Employee Well-being:Mental physical and financial wellness programs (free gym memberships virtual care appointments mental health services and discount programs).
Professional Development:Ongoing learning and career advancement opportunities.
More about Copper Springs
Copper Springs is a behavioral health hospital located in Avondale AZ part of the greater Phoenix metro area. We provide inpatient and outpatient programming for those facing mental health and addiction challenges. Our programs offer caring compassionate treatment for adolescents and adults as well as specialized programming for active-duty military veterans first responders and other high-risk frontline professionals.
Programs include inpatient mental health and addiction treatment Partial Hospitalization Programs (PHP) Intensive Outpatient Programs (IOP) and Help for Heroes.
EEOC Statement
Copper Springs is an Equal Opportunity Employer. Copper Springs is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment.
Key Skills
- Customer Service
- Communication skills
- Basic Math
- Cashiering
- Computer Skills
- Math
- Retail Sales
- 10 Key Calculator
- Copywriting
- Cash Handling
- Planograms
- Stocking
About Company
Lifepoint Health is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 a ... View more
