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Work from Home Hiring for Clerical Utilization Review Job at Nashville, TN Full Time
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Description
Introduction
Do you want to join an organization that invests in you as a(an) Clerical URS? At HCA, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years.
Benefits
At HCA, we want to ensure your needs are met. We offer eligible colleagues an attractive benefit package that includes medical, wellbeing, dental and vision benefits along with some unique benefits including:
- Medical, Dental, Vision, Life Insurance and Flexible Spending
- Paid Time Off (PTO) and Personal Leave
401K (100% annual match – 3% to 9% of pay based on years of service)
Academic Assistance and Reimbursements for Tuition and Student Loans
Employee Discounts including Tickets, Retail, Mental Health Apps, Education Apps, Identity Theft Protection etc.
Home, Auto, and Pet Insurance- Employee Stock Purchase Program (ESPP)
Short Term & Long Term Disability coverage
Adoption Assistance
Legal Benefits and lots more!
Learn more about Employee Benefits
You contribute to our success. Every role has an impact on our patients’ lives and you have the opportunity to make a difference. We are looking for a dedicated Clerical URS like you to be a part of our team.
Job Summary and Qualifications
Provides clerical support to the Utilization Review Services staff as related to authorization procurement and concurrent denial mitigation, for the North Carolina Division.
Special Qualifications
Excellent communication skills: ability to interact with multiple internal and external vendors/departments in a clear, concise and professional manner. Organization skills – able to proactively prioritize needs and effectively manage time. High comfort level with computer and computer programs (Word, Excel, MS Outlook, Midas, Meditech and OnBase).
Licensure/Certification/Registration
Excellent personal computer skills (MS Outlook, MS Office, Midas, EMR, OnBase and other related software).
Hours of Work
Schedule flexible as per UR department needs, some weekend and or holiday work may be required.
Specific Elements and Essential Functions
Document payor communications in Midas related to authorizations and concurrent denials
Identify accounts requiring follow up by reviewing reports, such as Tableau accounts requiring follow up and Midas Discharge report- auth / cert follow up
Fax clinical information as instructed via nH Discharge
Monitor payor letters received via payor letter retention / Right Fax process following HCA guidelines
Provide payors with discharge date or discharge summary, as needed
Answer and record inbound calls from payors, tagging calls with account number using UCCE Call Recording system
Manage Midas Send Payor Non-response and no authorization documented worklist rules and document appropriately
Demonstrate knowledge and effective use of multiple applications, systems and resources
example, but not limited to: Call Recording, WebEx Teams, Electronic Health Records, Payor portals, Right Fax, Share Point sites and OnBase
Support Central UR nurses in a clerical function as needed or requested
High School Graduate/Equivalent, required
Associate’s degree, preferred
0-2 years work experience, required
HCA Healthcare (Corporate), based in Nashville, Tennessee, supports a variety of corporate roles from business operations to administrative positions. Like our colleagues in any HCA Healthcare hospital, our corporate campus employees enjoy unparalleled resources and opportunities to reach their potential as healthcare leaders and innovators. From market rate compensation to continuing education and career advancement opportunities, every person has a solid foundation for success. Nashville is also home to our Executive Development Program, where exceptional employees are groomed to take on CNO- and COO-level roles in our hospitals. This selective program focuses on ethics, leadership and the financial and clinical knowledge required of professionals at this level of the industry.
HCA Healthcare has been named one of the World’s Most Ethical Companies by Ethisphere Institute for over a decade. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.
“Good people beget good people.”- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder
We are a family 270,000 dedicated professionals! Our Talent Acquisition team is reviewing applications for our Clerical URS opening. Qualified candidates will be contacted for interviews. Submit your resume today to join our community of caring!
We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
