What are the responsibilities and job description for the Denial Recovery Coordinator | Utilization Review | FT Days position at UF Health Central Florida?
Overview
UF Health Leesburg Hospital has been serving the health care needs of our community for 58 years. The hospital offers advanced cardiac care including one of the largest cardiothoracic surgery programs in the state. The American College of Cardiology has recognized UF Health Leesburg Hospital for its demonstrated expertise and commitment in treating patients with chest pain by awarding a Chest Pain Center Accreditation with Primary PCI and Resuscitation — its highest and best level of accreditation. UF Health Leesburg Hospital also offers advanced orthopedic surgery, stroke care, emergency services as well as labor and delivery care.
The hospital is part of UF Health Central Florida, a not-for-profit health care system and the largest most comprehensive provider of health care services in the region. UF Health Central Florida provides inpatient acute hospital services at UF Health Leesburg Hospital and UF Health Spanish Plaines Hospital, inpatient rehabilitation services at UF Health Rehab Hospital - The Villages and diagnostic laboratory services at several locations. We take pride in providing progressive, innovative technology, along with building strong relationships with patients, families, physicians and residents of the communities we serve.
Responsibilities
Under the general supervision of the Utilization Management Director, the Denial Recovery Coordinator is responsible for hospital wide management and coordination of utilization and external review activities related to payor issues to ensure an active and effective utilization and denial management program. All duties are performed in accordance with the utilization review plan, Federal and State guidelines, as well as The Joint Commission standards.
Qualifications
Education
UF Health Leesburg Hospital has been serving the health care needs of our community for 58 years. The hospital offers advanced cardiac care including one of the largest cardiothoracic surgery programs in the state. The American College of Cardiology has recognized UF Health Leesburg Hospital for its demonstrated expertise and commitment in treating patients with chest pain by awarding a Chest Pain Center Accreditation with Primary PCI and Resuscitation — its highest and best level of accreditation. UF Health Leesburg Hospital also offers advanced orthopedic surgery, stroke care, emergency services as well as labor and delivery care.
The hospital is part of UF Health Central Florida, a not-for-profit health care system and the largest most comprehensive provider of health care services in the region. UF Health Central Florida provides inpatient acute hospital services at UF Health Leesburg Hospital and UF Health Spanish Plaines Hospital, inpatient rehabilitation services at UF Health Rehab Hospital - The Villages and diagnostic laboratory services at several locations. We take pride in providing progressive, innovative technology, along with building strong relationships with patients, families, physicians and residents of the communities we serve.
Responsibilities
Under the general supervision of the Utilization Management Director, the Denial Recovery Coordinator is responsible for hospital wide management and coordination of utilization and external review activities related to payor issues to ensure an active and effective utilization and denial management program. All duties are performed in accordance with the utilization review plan, Federal and State guidelines, as well as The Joint Commission standards.
Qualifications
Education
- Bachelor’s Degree preferred
- Florida Registered Nurse license
- Must be able to read, speak, and write in English
- Min of 2 years’ experience performing utilization review in a hospital setting, for a third party payor or other review agency or organization
- Knowledge of diagnostic related groups (DRGs), Federal and State guidelines, commercial and other payor groups and ICD-10-CM coding preferred
- Must possess strong written and verbal communication skills
- Ability to type and use computer required
