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Utilization Review Specialist

Universal Health Services, Inc.

ATLANTA, GA, 30309, USA

Job Code:
22742 Facility:
Anchor Hospital Location:
ATLANTA, GA US Travel Involved:
None Job Type:
Full Time Job Level:
Experienced (Non-Manager) Minimum Education Required:
Bachelor's Degree Skills:
Health Care ->Accounting/Billing, Behavioral Health, Patient Admissions Category:
Professionals FTE:
1.00 Position Summary:
1. &n bsp; Conduct admission reviews working with Assessment and Referral Services to stay abreast of admissions. 2. &n bsp; Conduct concurrent and extended stay reviews on appropriate day and/or specified time. 3. &n bsp; Prepare and submit appeals to third party payers, effectively coordinating collection of all pertinent data to support the hospital and patient’s position. 4. &n bsp; Maintain and update logs of review and maintain other appropriate records of the Utilization Review department. 5. &n bsp; Stay abreast of applicableURtrends. 6. &n bsp; Communicate pertinent third party payer issues to doctor and treatment team. 7. &n bsp; Attend daily treatment team meetings to discuss acuity issues, third party payer needs and gather information for reviews. 8. &n bsp; Work independently in gathering information for reviews from the patient record, taking the initiative to seek information from members of the treatment team. 9. &n bsp; Understand and communicate insurance information to team members, including benefits and levels of care offered. 10. &n bsp; Perform internal utilization reviews as indicated. 11. &n bsp; Prepare any reports assigned or requested by Director of Utilization Review. 12. &n bsp; Perform other duties as assigned. 13. &n bsp; Support facility internal and external customer service standards. 14. &n bsp; Follow Anchor Hospital Time and Attendance policy. Requirements Bachelor’s Degree;proactively monitor utilization of continuum services and optimize reimbursement. To submit your application for this job, select how you heard about the job and then click the "Submit Your Application" button below. 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