Description
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Utilization Specialist
101 Truman Medical Center
**Job Location**
Truman Support Center
Kansas City, Missouri
**Department**
Central Access Services UHTMC
**Position Type**
Full time
**Work Schedule**
8:00AM - 4:30PM
**Hours Per Week**
40
If you want to work where the action is, University Health (UH) is the place for you. Known as "Kansas City's Essential Hospital," UH is the safety net healthcare system for Jackson County/Kansas City. We are an academic medical center, serving as the primary teaching institution for the UMKC Schools of Medicine, Nursing, Dentistry, and Pharmacy. A 547-bed, not-for-profit health system, UH delivers the highest-quality medical care for our patients, with compassion, empathy, and unparalleled dedication to service. During the 2020 pandemic, we also stepped forward as a regional leader in COVID care and testing. UH is comprised of three campuses:
**UH Truman Medical Center** is located in the Health Sciences District of downtown Kansas City, Missouri. The Health Sciences District represents a robust academic community, leading the forefront of biomedical research and cutting edge technology. Partnered with UMKC and Children's Mercy Hospital. University Health serves as the cornerstone in educating the next generation of healthcare practitioners. As a Level 1 Trauma Center, we're a leader in Emergency Medicine and Critical Care, with world-class expertise in chronic disease management and women's services, including high-risk maternity care. The Health Sciences District is also home to the University Health 1 and 2 buildings. UH 1 is UH's beautiful specialty outpatient clinics and day-surgery center and UH 2 is the location for all of our primary care and women's care clinics.
**UH Lakewood Medical Center** is located between Kansas City and Lee's Summit, Missouri, offering residents of Eastern Jackson County access to a modern community hospital with a continuum of outpatient services designed to meet the needs of families. UH Lakewood specializes in high-risk maternal and child care, and serves as one of the few Kansas City metro area institutions accredited by The Joint Commission in Orthopedics and Palliative Care. It also is home to a 188-bed, fully accredited long-term care center.
**UH Behavioral Health** is the KC metro area's largest, most comprehensive provider of mental health services. The **Crossroads Building** , located in Kansas City's vibrant Crossroads Arts District, is its epicenter, providing a broad list of outpatient services. We also offer psychiatric inpatient care, and we deliver therapeutic services through our community outreach clinics. We are a leader in the Trauma-Informed Care Movement, and provide training, coaching and consulting to outside organizations.
**Job Description**
The Utilization Specialist can be the first point of contact for many patients regarding financial clearance for their procedure or hospital stay. This position is responsible for providing a positive and inviting image to the patient and family.
The Utilization Specialist will verify all financial and insurance information, obtaining appropriate pre-certification and authorization, collecting copays and deductibles, completes all authorization/notification paperwork, and Assists with training new and existing staff and can be relied upon to lead and train staff in preparation for special projects.
They will ask key questions to help facilitate the prior authorization and scheduling process for specified procedures and Admission Notifications. Utilization staff will need to work with FCC Staff for all self-pay patients to review eligibility for the University Health Discount and/or Medicaid. The Utilization Specialist will be expected to communicate financial responsibility to the patient and communicate with clinics and/or physicians with any concerns. In some clinic settings Patient Responsibility will be communicated by the scheduler.
The Utilization Specialist is responsible for facilitating the flow of information between the clinical areas, Utilization Management, insurance company and the Patient Accounting Department as well as documenting all pertinent information in Revenue Cycle through the Enhanced Authorization Process.
Minimum Requirements
High school diploma or equivalent.
Experience in healthcare insurance verification and billing protocols.
Two years' experience in face to face and/or customer service or equivalent field. Working knowledge of medical terminology, CPT codes, and ICD9 codes.
Ability to type 30 wpm.
Communication and customer service skills required to gather and exchange information with patients, families, hospital staff members, physicians and third party payers.
Ability to work and think independently with limited supervision, ability to handle sensitive information, with discretion, great attention to detail, ability to handle multi-tasking and change in priorities.
Working knowledge and efficiency in Microsoft products (Outlook, Word, Excel, Access, & Power Point).
Willing to become familiar with other software programs.
Preferred Qualifications
Experience in Procedure Authorizations and Inpatient Admission Notifications
Prior Experience working with Clinicians or Utilization Management Prior
Experience in registration or working with insurance eligibility
Course work in medical terminology and coding.
**Working at University Health is about making a difference. It's providing the best care to every patient every day.**
University Health (UH), is committed to being a leader in providing a culturally inclusive workplace for our employees. UH is an equal opportunity employer. We value and celebrate our differences. We are committed to equal employment opportunity regardless, but not limited to race, ethnicity, religion, beliefs, sex (including pregnancy, gender identity and expression, sexual orientation), national origin, ancestry, language, age, citizenship, genetic information, marital status, socioeconomic status, literacy, disability, mobility, abilities, veteran status and any other category protected by applicable law.
Compensation Information:
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