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Independent Health

Associate Medical Director - UM PT

$115 - $155/hr

... Medical Director in the oversight of Utilization Management (UM) programs and will support the ... Excellent verbal, written and interpersonal communication skills required. * Solid computer ...

Independent Health Association

$115 - $155/hr

... Medical Director in the oversight of Utilization Management (UM) programs and will support the ... Excellent verbal, written and interpersonal communication skills required. * Solid computer ...

Altais, Inc.

UM Medical Director - Casual

Coordination of prospective, concurrent, retrospective review including denial and/or approval of ... Develop and maintain written medical care protocols and assure UM Standardization. * Chart Reviews ...

Altais

UM Medical Director - Casual

California, MO · On-site

$223 - $267/hr

Coordination of prospective, concurrent, retrospective review including denial and/or approval of ... Develop and maintain written medical care protocols and assure UM Standardization.* Chart Reviews ...

Altais, Inc.

UM Medical Director - Casual

... Director as a resource person for Physician Education on UM and input into the One Altais UM goals ... Coordination of prospective, concurrent, retrospective review including denial and/or approval of ...

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UM Denial Coordinator 8755 #13925

Oroville Hospital

Oroville, CA • On-site

$19.28 - $24.35/hr

Part-time

Posted 14 days ago

Oroville Hospital rating

6.1

Company rating: 6.1 out of 10

Based on 22 frontline employees who took The Breakroom Quiz

850th of 1,061 rated hospitals

Job description

Job #: 13925
Job Category: Nursing
Job Type: Part Time
Shift Type: Variable
Facility:
Department: Case Management
Pay Range: $19.28/hr. - $24.35/hr.
Open Date: 08.13.26
Close Date:
Qualifications:
  • High School Graduate or Equivalent
  • Bachelor's Degree in related field preferred
Job Details:
Start Date:
Open Until Filled. This part-time position requires 40-47 hours worked per pay period.
Qualifications:
  • High School Graduate or Equivalent
  • Bachelor's Degree in related field preferred
  • Knowledge and ability to use effectively Microsoft Word, Excel, PowerPoint, Access, Outlook
  • Excellent telephone skills
  • Competent oral, written and composition skills
  • Ability to follow written and oral directions
  • Demonstrates high level of personal and professional accountability and responsibility
  • Self-directed and performs duties independently
  • Ability to problem-solve and apply critical thinking skills
  • Must have the proven ability to maintain confidentiality
  • Must demonstrate excellent customer service and communication skills
  • Ability to effectively communicate and coordinate daily work flow to ensure department needs are met
  • Must be flexible, dependable, and demonstrate the ability to adapt to change
Duties &
Responsibilities:
Job Summary
The Denial Coordinator carries through to completion, specific work projects assigned by Director of Case Management, the Assistant Director of Case Management and services relative to; overseeing the appeal and denial process that includes, preventing denials, generating and processing denial letters, maintaining denial and appeal logs. Performs a variety of routine daily tasks; reviews reports, prepares correspondence; and participates in special department projects.
Duties
Administrative Duties
  • Schedule department staff meetings, bi weekly UM/UR committee meetings and quarterly executive UM/UR committee meeting and ensure preparation of agenda and minutes and coordinating activities including scheduling, set up, food service, visual aids, etc...
  • Acts as recording secretary for the UM/UR committee and UM/UR executive committee
    • Track and prepare needed documentation for quarterly CQI projects
  • Oversee new hire training and ongoing development for department secretaries
  • Ensure integrity and quality of department secretarial duties such as timelines of UR sent to insurances, ensure proper documents are provided to insurances, oversee the work and maintenance of outstanding accounts on ANSB and that certification and denials are handled in a timely manner.
  • Develop and maintain training and continuing education materials and process for various positions in the department
  • Scheduling Department meetings, In-services and interviews for potential candidates
Denial & Appeal Management
  • Tracking denials and appeal status to ensure timely processing
  • Analyze correspondence from insurances from denial and appeal to track results and monitor for trends and report findings
  • Work as a liaison for the department with Patient Financial Services and Patient Access to communicate issues that cause denials and help to prevent the causation of denials
  • Assembles data relative to denials and appeal outcomes
  • Data entry into various software products
  • AS400, ability to run queries and access billing records and demographic information
  • Must be able to multitask and facilitate workflow to meet deadlines. Must meet deadlines as assigned
  • Coordinate and facilitation of chart audits which may include analysis of correct charting, charge entry
  • Performs other duties as assigned
Other Info:
Organizational Expectations
  • Provides a positive and professional representation of the organization.
  • Promotes culture of safety for patients and employees through proper identification, reporting, documentation, and prevention. Maintains hospital standards for a clean and quiet patient environment to maintain a positive patient care experience.
  • Adheres to infection-control policies and protocols.
  • Participates in ongoing quality improvement activities.
  • Maintains compliance with organization's policies, as well as established practices, protocols, and procedures of the position, department, and applicable professional standards.
  • Complies with organizational and regulatory policies for handling confidential patient information.
  • Demonstrates excellent customer service through his/her attitude and actions, consistent with the standards contained in the Vision, Mission, and Values of the organization.
  • Adheres to professional standards, hospital policies and procedures, federal, state, and local requirements.
Lifting Requirements: Semi- Sedentary: Sits and walks throughout workday. Generally lifting objects not more than 25 lbs. and/or carrying objects weighing 10 lbs.
Job Posted:
08/13/2026

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About Oroville Hospital

Sourced by ZipRecruiter

Oroville Hospital, located in Oroville, CA, US, is a prominent healthcare institution that has been providing medical services since its foundation in 1962. The hospital operates in the healthcare industry, offering a broad range of services including surgical care, maternity services, emergency care, and specialized treatments, among others. The organization differentiates itself as a non-profit community-focused healthcare provider. Built upon core values of integrity, compassion, collaboration, and excellence, Oroville Hospital aims to provide the highest quality healthcare to the residents of Butte County and the surrounding communities. The mission of Oroville Hospital is to ensure the best patient care by employing highly skilled professionals and offering advanced treatments using modern medical equipment. The organization's notable achievements include obtaining the Joint Commission's Gold Seal of Approval for Hospital Accreditation, demonstrating commitment to providing safe and effective patient care.

Company size

1,001 - 5,000 Employees

Headquarters location

Oroville, CA, US

Year founded

1962

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