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Jobs · OTHR · California

Per Diem-Admitting Worker PRN-Utilization review-Los Alamitos-Days

UCI Health · Los Alamitos, CA · 2 wk ago
On-siteOTHRFull-time

UCI Health is one of California's largest academic health systems and the clinical enterprise of the University of California, Irvine. Established on July 1, 1976, UCI Health has grown into a 1,461-bed health system that includes UCI Health - Orange, UCI Health - Irvine, four Community Network hospitals and a growing network of ambulatory care centers across Orange and Los Angeles counties. As Orange County’s only academic health systems, UCI Health is home to the only National Cancer Institute-designated comprehensive cancer center based in the county, the region’s only American College of Surgeons-verified Level I adult and Level II pediatric trauma center, American College of Emergency Physicians Gold Level 1 Geriatric Emergency Department and a nationally recognized regional burn center verified by the American Burn Association. Powered by UC Irvine, UCI Health serves 5.6 million people across Orange County, western Riverside County and southeast Los Angeles County through excellence in patient care, research and medical education.

Responsibilities

  • Follow up on patient accounts when authorization for stay is required, Fax numbers to Send clinical reviews
  • Follow up on each account during the stay and on discharge for authorization - document in the electronic system
  • Escalate any potential disputes or denial of accounts to Director of Case Management or designee
  • Trends disputed claims by at least payor and physician
  • Assist in obtaining authorization for patient discharged to Skilled Facilities or other post-acute care that require authorization
  • Other duties as assigned

Requirements

  • Must possess the skill, knowledge and ability essential to the successful performance of assigned duties
  • Must demonstrate customer service skills appropriate to the job
  • Excellent written and verbal communication skills in English
  • Ability to maintain a work pace appropriate to the workload
  • Ability to establish and maintain effective working relationships across the Health System
  • High school diploma or equivalent required
  • Skills required include excellent organizational skills, excellent verbal and written communication skills
  • Demonstrated problem solving skills
  • Computer literacy

Qualifications

  • Knowledge of University and Medical Center organizations, policies, procedures and forms
  • Associate or Bachelor's degree preferred
  • Paramedic, EMT or Nursing Assistant certification preferred
  • Acute hospital experience preferred
  • Data Analytic skills preferred

Skills

  • Excellent organizational skills
  • Excellent verbal and written communication skills
  • Problem solving
  • Computer literacy
  • Customer service skills
  • Ability to maintain work pace appropriate to workload
  • Ability to establish and maintain effective working relationships across the Health System

Benefits

We offer a wealth of benefits to make working at UCI even more rewarding. These benefits may include medical insurance, sick and vacation time, retirement savings plans, and access to a number of discounts and perks. Please utilize the links listed here to learn more about our compensation practices and benefits.

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