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Weekday Insurance Utilization Review Jobs in Arizona

Dane Street

Orthopedics Physician

Concho, AZ · On-site

... peer review services, trusted by insurance carriers and organizations across the country for ... and utilization review/management expertise * Expanded credentials as an expert in Independent ...

Universal Health Services

DISCHARGE PLANNER

Phoenix, AZ · On-site

PRN Varies The Discharge Planner works with the Utilization Review department on certification and recertification of insurance benefits throughout the patient's stay, and assists the treatment team ...

UHS

DISCHARGE PLANNER

Phoenix, AZ · On-site

PRN Varies The Discharge Planner works with the Utilization Review department on certification and recertification of insurance benefits throughout the patient's stay, and assists the treatment team ...

Chubb

Senior Property Claims Specialist

Phoenix, AZ · On-site

... weekdays as needed. * Complete desk re-inspections, subrogation reviews, and other duties as ... Chubb is a world leader in insurance. With operations in 54 countries, Chubb provides commercial ...

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All JobsWeekday Insurance Utilization Review JobsWeekday Insurance Utilization Review Jobs in Arizona

Weekday Insurance Utilization Review information

What is the difference between Weekday Insurance Utilization Review vs Weekday Claims Processor?

AspectWeekday Insurance Utilization ReviewWeekday Claims Processor
Primary RoleAssessing medical necessity and appropriateness of servicesProcessing and reviewing insurance claims for payment
CredentialsOften requires healthcare or insurance certificationsTypically requires insurance or administrative experience
Work EnvironmentHealthcare settings, insurance companiesInsurance companies, healthcare offices
FocusMedical review and authorizationClaims data entry and verification

Weekday Insurance Utilization Review focuses on evaluating medical necessity, while Weekday Claims Processors handle the administrative processing of insurance claims. Both roles are essential in the insurance industry but serve different functions related to claims management and healthcare authorization.

What cities in Arizona are hiring for Weekday Insurance Utilization Review jobs?

Cities in Arizona with the most Weekday Insurance Utilization Review job openings:

Weekday Insurance Utilization Review jobs near you

Case Manager / PRN ( RN / RT / SW / LPN )

Select Specialty Hospital - Downtown Phoenix

Phoenix, AZ • On-site

Per diem

Life, Retirement

Posted 7 days ago

Select Specialty Hospital rating

7.6

Company rating: 7.6 out of 10

Based on 92 frontline employees who took The Breakroom Quiz

262nd of 1,065 rated hospitals

Job description

Overview
Select Specialty Hospital
Critical Illness Recovery Hospital (LTACH)
Case Manager (PRN)
Requires a current licensure in a clinical discipline either as a Nurse or a Respiratory Therapist OR Social Work SW/MSW (potential license per state guidelines).
And
Previous discharge planning experience highly preferred.
SHIFT:
*Availability to work a minimum of 2 shifts per month on an "as needed" basis - shifts would be scheduled on weekdays, from appoximately 8a.m.-5p.m.*
Our hospital is a critical illness recovery hospital committed to providing world-class inpatient post-ICU services to chronic, critically ill patients who require extended healing and recovery. We help patients during some of the most vulnerable, painful moments of their lives - and our team plays a central role in providing compassionate, excellent care every step of the way.
Responsibilities
We are looking for valued employees who will be Champions of the Select Medical Way, which includes putting the patient first, helping to improve quality of life for the community in which you live and work, continuing to develop and explore new ideas, providing high-quality care and doing well by doing what is right.
The Case Manager is responsible for utilization reviews and resource management, discharge planning, treatment plan management and financial management, while also completing medical record documentation. You will report directly to the Director of Case Management and provide social work services, as necessary, per state guidelines.
  • Develops and implements a patient specific, safe and timely discharge plan.
  • Performs verification of utilization criteria reviews.
  • Builds relationships and coordinate with payor sources to assure proper reimbursement for hospital provided services, promote costs attentive care via focus on resource management within the plan of care.
  • Demonstrates compliance with facility-wide Utilization Management policies and procedures.
  • Coordinates UR compliance with Quality Management to assure all licensure and accrediting requirements are fulfilled.
  • Maintains fiscal responsibilities. Assures the department is identifying and negotiating the fullest possible reimbursement to maximize insurance benefit coverage for the patient. Reviews insurance verification forms to minimize risk.
  • Facilitates multi-disciplinary team meetings including physicians, nurses, respiratory therapists and rehabilitation therapists.

Qualifications
How you will be successful in this environment:
We are seeking results-driven team players. Qualified candidates must be passionate about providing superior quality in all that they do.
Minimum requirements:
  • Current licensure in a clinical discipline either as a Nurse (RN /LPN/ LVN)or a Respiratory Therapist OR current license / certified Social Work license per state guidelines
  • Previous RN/LPN/RT/SW/CM experience in an inpatient hospital setting dealing with critical care/acute care patients. (example: ICU, step-down, med surg, vents)
  • Adequate experience in an acute medical case management setting and confidence to manage and direct a plan of care for chronically critically ill populations

Preferred qualifications that will make you successful:
  • Specific experience in Care Management and Discharge Planning is preferred.
  • Working knowledge of the insurance industry and government reimbursement.
  • Availability to work a minimum of 2 shifts per month on an "as needed" basis - shifts would be scheduled on weekdays, from appoximately 8a.m.-5p.m.

Additional Data
Why Join Us:
  • Start Strong: Extensive orientation program to ensure a smooth transition into our setting.
  • Opportunity for Advancement: Demonstrate your skills and dedication which could lead to potential full-time opportunities
  • Foster Well-being: We offer benefits which support the financial, work/life and emotional well-being of you and your family members. Part time/Per Diem positions are eligible for 401k based on reaching 1,000 hours within their first anniversary or subsequent calendar year. We also offer our employee assistance program to part time employees.
  • Your Impact Matters: Join a team of over 44,000 committed to providing exceptional patient care

Equal opportunity employer, including disabled veterans

What Select Specialty Hospital employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

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About Select Specialty Hospital

Sourced by ZipRecruiter

Select Specialty Hospital is a top-tier healthcare services provider situated in Mechanicsburg, PA, US. Operating under the wider umbrella of the healthcare industry, Select Specialty Hospital is a part of a network of specialized acute care hospitals energized to provide superior, patient-centered treatment. Since its establishment, it has been a pioneer in providing long-term acute care (LTAC) services to patients transitioning from intensive care or requiring concentrated care for ongoing recovery.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Mechanicsburg, PA, US

Social media

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