Medical Review Coordinator

Overview

Department: Utilization Review
Shift: Full-Time
Facility: St Mary's Hospital
Location: Kankakee, IL

Responsibilities

• Coordinates and reviews all medical records, as assigned to caseload
• Actively participates in Case Management and Treatment Team meetings
• Serves as on-going educator to all departments
• Reviews patient charts to assess whether criteria for admission and continuation of treatment is being met
• Gathers data and responds to requests for records from payers/fiscal intermediary
• Gathers clinical and fiscal information and communicates status of both open and closed accounts for multiple levels of Utilization Review and Case Management reporting
• Works independently and uses sound judgment
• Applies knowledge of Federal, State, and intermediary guidelines related to inpatient, acute care hospitalization, as well as lower levels of care for continuity of treatment
• Coordinates discharge referrals as requested by clinical staff, fiscal intermediary, patients, and families
• Performs other duties as assigned

Qualifications

Required

• Medical Graduate, Dental Graduate, PA, or Nursing Graduate required

Preferred

• ECFMG Certification
• Bachelor's or higher from a US-based accredited institution in a Health and Human Services field is highly preferred
• Utilization Review experience is highly preferred
• Clinical experience in acute care setting preferred
• Excellent written and verbal communication skills
• Excellent critical thinking skills
• Excellent interpersonal skills to build effective partnering relationships with physicians, nurse staff, coding staff and hospital management staff
• Ability to work independently in a time-oriented environment

Pay

A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $31 to $44.90. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

Benefits

Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. The company is dedicated to empowering its staff with a comprehensive, competitive benefits package, allowing them the freedom to customize their benefits to fit their unique needs. Our abundant resources, programs, and voluntary options serve as a foundation for individual growth and well-being.

Schedule

Employment Status: Full Time
Shift: Days