Utilization Coordinator - Full-Time

Responsibilities

Join the Southwest Healthcare Team!

About Us :

Creating Health and Harmony, Southwest Healthcare is a comprehensive network of care with convenient hospital and ambulatory care / outpatient locations here to serve the Southern California community. With over 6,000 passionate providers and healthcare employees, our shared goal is to provide convenient access to a wide range of healthcare services in a way that benefits you, your family, and the entire community.

Southwest Healthcare is comprised of five acute care hospitals and several non-hospital access points, including : Corona Regional Medical Center, Palmdale Regional Medical Center, Southwest Healthcare Rancho Springs Hospital, Southwest Healthcare Inland Valley Hospital and Temecula Valley Hospital, Temecula Valley Day Surgery, A+ Urgent Care Centers, and Riverside Medical Clinics. For more information on how to join our dynamic team , please visit our website at www.swhealthcaresystem.com .

Job Summary :

The Southwest Healthcare Regional office in Temecula, CA is seeking a Full-Time Utilization Coordinator who will supports the Centralized Utilization Review department and collaborates with staff across the Southern California Region. Duties include but not limited to :

• Outreach to payers via phone or fax for authorization / denial outcomes.
• Accesses payer portals daily to retrieve authorizations / denials and records outcomes.
• Reconciles all payer correspondences and runs daily department reports, taking action if needed.
• Run daily department reports and take action if needed.
• Enter all denials received into Artiva, manage worklist, and facilitate peer to peer.
• Maintains Medi-Cal TAR logs and audits, accesses Medi-Cal portal to submit required documents.
• Retrieves and delivers messages from Utilization Review Dept phone review line at least 4 times per day.
• Answers telephone professionally and courteously.
• Performs other related duties as requested by the UM Manager.

Qualifications

Experience / Training / Experience :

Certifications / Licenses :

Other Skills and Abilities :

Benefit Highlights :

Southwest Healthcare is owned and operated by subsidiaries of Universal Health Services, Inc. (UHS) , a King of Prussia, PA-based company, one of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (NYSE : UHS) has built an impressive record of achievement and performance, growing since its inception into a Fortune 500 corporation. Headquartered in King of Prussia, PA, UHS has 99,000 employees. Through its subsidiaries, UHS operates 28 acute care hospitals, 331 behavioral health facilities, 60 outpatient and other facilities in 39 U.S. States, Washington, D.C., Puerto Rico and the United Kingdom.

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.

Avoid and Report Recruitment Scams :

We are aware of a scam whereby imposters are posing as Recruiters from UHS, and our subsidiary hospitals and facilities. Beware of anyone requesting financial or personal information. At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.