Location: Steward Health Care
Posted Date: 5/8/2023
The Utilization Review Authorization Coordinator Educator will work with the Utilization Review Authorization Coordinator Lead and the Utilization Coordination Manager to maintain up to date education for the department. Identify areas for improvement and work with UR Managers, UR Leads, and Care Management Team to positively impact outcomes.
- Responsible for overseeing the onboarding process for new team members.
- Coordinating opportunities for education and workflow optimization.
- Develop and maintain training materials.
- Assist in maintaining department policies, processes, and competencies.
- Identifying areas of improvement in daily processes.
- Providing educational presentations on identified topics on a minimum of a monthly basis.
- Providing individualized education when needed.
- Keeping up to date records of available payor portals and their user guides.
- Attending monthly organization meetings as assigned.
- Attention to detail regarding documentation and follow-up to ensure process is completed in a timely manner.
- Effectively interact with all levels of the organization and maintain cooperative relations with internal and external customers.
- Document authorization numbers, concurrent denial, attempts to overturn concurrent denials and coordinate Peer-to-Peer communication as needed for all patient hospital stays.
- Follow-up communication with payors to ensure authorization obtained for patient hospitalization.
- Communicate appropriately with Utilization Review Team and Case Management team members to ensure patient and payor needs are met.
- Additional duties as assigned.
REQUIRED KNOWLEDGE & SKILLS:
- Good organizational skills.
- Ability to analyze data to determine underling trends.
- Ability to assist in development and process improvement in obtaining payor authorization and concurrent denials.
- Manages time effectively, sets priorities, and consistently meets deadlines.
- Excellent verbal, written, and presentation communication skills.
- Ability to effectively demonstrate appropriate interactions with insurance companies.
- Demonstrates initiative and pro-active approach to problem resolution.
- Performs well independently and on a team.
- Assumes accountability for demonstrating behaviors consistent with the customer service policy.
- Works competently with computer based charting and other clinical and non-clinical software programs.
- Readily adapts to change.
- Operates office equipment efficiently.
- Ability to create analytic documentation and presentations.
- Critical thinking skills required.
- Medical Terminology.
- Education: Minimum High School graduate or GED equivalent[ML1] .
- Experience (Type & Length): Minimum 3 years’ experience as an authorization coordinator or similar role. Minimum 1 year experience as a trainer/preceptor.
- Software/Hardware: Proficient computer skills required, i.e. Word, Excel, Microsoft Office
- Other: Understanding of the health care delivery setting. Ability to read and communicate effectively in English required, ability to communicate in additional languages preferred.