UR COORDINATOR
talentifyioLawrenceville, GA
UR COORDINATOR
talentifyioLawrenceville, GA
8 days ago
Occupations
Medical and Health Services ManagersHealth Information Technologists and Medical RegistrarsMental Health and Substance Abuse Social WorkersIndustries
Psychiatric and Substance Abuse HospitalsGeneral Medical and Surgical HospitalsOutpatient Mental Health and Substance Abuse CentersAbout the role
Responsibilities:
SummitRidge Hospital provides quality behavioral health and addiction treatment services in Lawrenceville, GA, approximately 30 miles northeast of downtown Atlanta. Our dedicated team of professionals provide caring and professional inpatient, outpatient and support services to adults and adolescents suffering from psychiatric or addictive disorders. Additionally, the Geriatric unit provides acute care for seniors in psychiatric crisis.
SummitRidge Hospital is seeking a PRN Utilization Review Coordinator to support our behavioral health facility on an as-needed basis. This role is responsible for coordinating utilization review activities, supporting timely insurance authorization processes, and ensuring compliance with payer requirements. The ideal candidate will have strong communication skills, attention to detail, and experience in behavioral health or utilization management.
Key Responsibilities:
Conduct utilization review functions for assigned patients in accordance with facility policies and payer guidelines
Obtain, track, and maintain insurance authorizations, continued stay reviews, and discharge planning updates
Communicate effectively with insurance companies, clinical staff, and other care team members
Ensure documentation is accurate, timely, and compliant with regulatory and payer standards
Support coordination of patient care updates related to level of care and medical necessity
Assist with appeals, denials, and other utilization management processes as needed
Maintain confidentiality and adhere to all HIPAA and facility privacy standards
About Universal Health Services One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $13.4 billion in 2022. During the year, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; and listed in Forbes ranking of America’s Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 94,000 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com
Qualifications:
High school diploma or equivalent required; associate’s or bachelor’s degree preferred
Previous experience in utilization review, case management, behavioral health, or a related healthcare setting preferred
Knowledge of insurance authorization processes, payer requirements, and medical necessity criteria
Strong organizational, communication, and problem-solving skills
Ability to work independently and maintain professionalism in a fast-paced environment
Proficiency with computer systems and electronic documentation
Previous experience with third party payors.
Must be familiar with utilization negotiations.
EEO Statement:
All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.
We believe that diversity and inclusion among our teammates is critical to our success.
Qualifications:
High school diploma or equivalent required; associate’s or bachelor’s degree preferred
Previous experience in utilization review, case management, behavioral health, or a related healthcare setting preferred
Knowledge of insurance authorization processes, payer requirements, and medical necessity criteria
Strong organizational, communication, and problem-solving skills
Ability to work independently and maintain professionalism in a fast-paced environment
Proficiency with computer systems and electronic documentation
Previous experience with third party payors.
Must be familiar with utilization negotiations.
EEO Statement:
All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.
We believe that diversity and inclusion among our teammates is critical to our success.
SummitRidge Hospital provides quality behavioral health and addiction treatment services in Lawrenceville, GA, approximately 30 miles northeast of downtown Atlanta. Our dedicated team of professionals provide caring and professional inpatient, outpatient and support services to adults and adolescents suffering from psychiatric or addictive disorders. Additionally, the Geriatric unit provides acute care for seniors in psychiatric crisis.
SummitRidge Hospital is seeking a PRN Utilization Review Coordinator to support our behavioral health facility on an as-needed basis. This role is responsible for coordinating utilization review activities, supporting timely insurance authorization processes, and ensuring compliance with payer requirements. The ideal candidate will have strong communication skills, attention to detail, and experience in behavioral health or utilization management.
Key Responsibilities:
Conduct utilization review functions for assigned patients in accordance with facility policies and payer guidelines
Obtain, track, and maintain insurance authorizations, continued stay reviews, and discharge planning updates
Communicate effectively with insurance companies, clinical staff, and other care team members
Ensure documentation is accurate, timely, and compliant with regulatory and payer standards
Support coordination of patient care updates related to level of care and medical necessity
Assist with appeals, denials, and other utilization management processes as needed
Maintain confidentiality and adhere to all HIPAA and facility privacy standards
About Universal Health Services One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $13.4 billion in 2022. During the year, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; and listed in Forbes ranking of America’s Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 94,000 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com
Qualifications:
High school diploma or equivalent required; associate’s or bachelor’s degree preferred
Previous experience in utilization review, case management, behavioral health, or a related healthcare setting preferred
Knowledge of insurance authorization processes, payer requirements, and medical necessity criteria
Strong organizational, communication, and problem-solving skills
Ability to work independently and maintain professionalism in a fast-paced environment
Proficiency with computer systems and electronic documentation
Previous experience with third party payors.
Must be familiar with utilization negotiations.
EEO Statement:
All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.
We believe that diversity and inclusion among our teammates is critical to our success.
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JOB OVERVIEW
Experience level
Senior
Location
Lawrenceville, GA
Occupation
Medical and Health Services Managers
Industry
Psychiatric and Substance Abuse Hospitals
Posted
8 days ago
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