Universal Health Services, Inc. (UHS) knows what it takes to lead, inspire and succeed. One of the Nation's largest and most respected hospital companies, UHS owns and operates through its subsidiaries acute care hospitals, behavioral health facilities and ambulatory centers in the United States, Puerto Rico, the U.S. Virgin Islands and the United Kingdom. Headquartered in King of Prussia, PA, UHS ranks on the Fortune 500 list of America's largest corporations with over 74,000 employees, and is consistently listed among Fortune's "Most Admired Companies" and one of the 30 Most Meaningful Companies To Work For in America by Business Insider.
University Behavioral Center, a subsidiary of Universal Health Services, Inc. (UHS), is committed to providing intensive mental health services to children, adolescents and adults as well as detox and substance abuse programs for adults. Our mental health facility provides safe and effective inpatient treatment to assist individuals in leading more productive and fulfilling lives. The facility is located on a beautiful 14-acre campus in Orlando, Florida, and includes 112 licensed beds.
We are currently looking for Full -Time Utilization Review Specialist to join our team of dedicated professionals. Hours will vary based upon department needs. Job requirements are to have flexibility Monday through Friday Day shift. Candidate must be willing to work around the holidays.
Core of Competencies:
Conduct concurrent and extended stay reviews on appropriate day and/or specified time.
Prepare and submit appeals to third party payors, effectively coordinating collection of all pertinent data to support the hospital and patient's position.
Maintain and update logs of review and maintain other appropriate records of the Utilization Review department. Stay abreast of applicable UR trends.
Communicate pertinent third party payors issues to Physician and treatment team.
Attend daily treatment team meetings to discuss acuity issues, third party payors needs and gather information for reviews.
Work independently in gathering information for reviews from the patient record, taking the initiative to seek information from members of the treatment team.
Understand and communicate insurance information to team members, including benefits and levels of care offered.
Perform internal utilization reviews as indicated.
Prepare any reports assigned or requested by Dir. Of Utilization Review.