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Utilization Review Spec III

Company: Cook Children's Health Care System
Location: Fort Worth
Posted on: September 13, 2019

Job Description:

Job Details

Position provides support for Utilization Review, Authorizations, Denials and Appeals functions. Assists licensed clinical staff by preparing medical records and clinical appeal information received by providers for review. Participation in utilization quality improvement for the utilization review department by assessing and identifying utilization review problems. Will also assist with submitting identified quality of care complaints to the appropriate department.This position also provides call issue escalation support and resolution for CCHP members or providers, or may provide support for Supervisor, during Supervisor's absence.

* High school diploma or equivalent required.

* Bachelor's degree preferred.

* Minimum seven years managed care experience or medical office experience, preferably in Utilization Review.

* Minimum three years in a Utilization Review role.

Cook Children's is an EOE/AA - Minority/Females/Disability/Vet

Keywords: Cook Children's Health Care System, Fort Worth , Utilization Review Spec III, Other , Fort Worth, Texas

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