Responsible for collection, organization, and triage of a worklist for both clinical review assignments and insurance denials for Utilization Management department. Working in collaboration with Utilization Management team of nurses and physician advisors to ensure timely handling of authorizations, and denials for hospitalized patients as well as for infusion center patients. Interacting with office-based pre-certification teams to assign routine pre-certifications for infusions. Validating and... more details
Responsible for collection, organization, and triage of a worklist for both clinical review assignments and insurance denials for Utilization Management department. Working in collaboration with Utilization Management team of nurses and physician advisors to ensure timely handling of authorizations, and denials for hospitalized patients as well as for infusion center patients. Interacting with office-based pre-certification teams to assign routine pre-certifications for infusions. Validating and releasing scheduling holds for infusion centers in a timely manner. Each aspect of the position has the primary goal of optimizing and ensuring submission of accurate information needed for both the timely and complete billing of services.
Education
High School Diploma or Equivalent (Required)
Bachelors Degree (Preferred)
Combination of relevant education and experience may be considered in lieu of degree.
Experience
1 Year experience in Data Management (Required)
1 Year experience in some combination of Utilization Management, Pre-Certifications or Denials (Required)
General experience in hospital or managed care utilization review and insurance requirements. (Required)
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Your Tomorrow is Here!
Temple Health is a dynamic network of outstanding hospitals, specialty centers, and physician practices that is advancing the fight against disease, pushing the boundaries of medical science, and educating future healthcare professionals. Temple Health consists of Temple University Hospital (TUH), Fox Chase Cancer Center, TUH-Jeanes Campus, TUH-Episcopal Campus, TUH-Northeastern Campus, Temple Physicians, Inc., and Temple Transport Team. Temple Health is proudly affiliated with the Lewis Katz School of Medicine at Temple University.
To support this mission, Temple Health is continuously recruiting top talent to join its diverse, 10,000 strong workforce that fosters a healthy, safe and productive environment for its patients, visitors, students and colleagues alike. At Temple Health, your tomorrow is here!
Equal Opportunity Employer/Veterans/Disabled
An Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.
Your Tomorrow is Here!
Temple University Hospital is a nationally respected teaching hospital on Temple University's bustling Health Sciences Center campus. The hospital provides a comprehensive array of healthcare services both basic and complex to patients from around the corner, across the country and around the world. As the chief clinical training site for the Lewis Katz School of Medicine at Temple University, the hospital provides a dynamic environment for high-quality care, teaching, and cutting edge research.
