Utilization Tech I - Utilization Management jobs in United States
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Chino Valley Medical Center · 13 hours ago

Utilization Tech I - Utilization Management

Chino Valley Medical Center is a community hospital recognized for its quality healthcare services. The Utilization Tech I role involves coordinating the utilization review and appeals process, managing communications with insurance providers, and supporting various departmental needs.

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H1B Sponsor Likelynote
Hiring Manager
Gabriela C.
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Responsibilities

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

Qualification

Denials management experienceMedical terminology knowledgeComputer data entryExcel skillsAlphabetic filing skillsNumeric filing skillsBusiness office trainingRegulations

Required

High School Diploma or equivalent required
Accurate alphabetic, numeric, and/or terminal-digit filing skills
Computer data entry with 10-key, with accurate typing speed of 35 wpm required

Preferred

Minimum one year denials management experience in acute care setting highly preferred
Excel skills highly preferred
Knowledge of terminal digit filing and medical terminology; preferred
Knowledge of State and Federal regulatory requirements for medical staff documentation; preferred
Completion of a medical terminology course; preferred
Background in business and office training; preferred

Benefits

Paid Time Off
401K retirement plan
Outstanding Medical
Dental
Vision Coverage
Tuition Reimbursement
Many more Voluntary Benefit Options!

Company

Chino Valley Medical Center

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Chino Valley Medical Center is a diverse population and incorporates elements of urban,suburban and rural medicine of patient services.

H1B Sponsorship

Chino Valley Medical Center has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2023 (1)

Funding

Current Stage
Growth Stage

Leadership Team

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Tim Moran
Chief Executive Officer
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Company data provided by crunchbase