Description

As industry-leading wound care providers, Healing Partners propel standard Skilled Nursing Facility wound care to a completely different level. Our multifaceted approach relieves various burdens – clinical, operational, financial, and practical – from busy owners, administrators, and employees, freeing each staff member to focus optimally on his or her responsibilities and improve overall facility management.

Benefits Of Working With Healing Partners

• Competitive salary/rate
• Monday-Friday day schedule
• Excellent schedule - no nights; no weekends; no on-call
• Benefits: Medical, Dental, Vision, eligible on 1st day of month following start date
• Employee Assistance Program (EAP)
• Health Savings Account (HSA)
• Dependent Care FSA
• 401k, Short Term/Long Term disability and life insurance
• Tuition Reimbursement
• Discount Programs
  
  

Utilization Review Coordinator Job Responsibilities

This position supports the Utilization Review and Quality Review Team with essential administrative functions. They are responsible for the timely submission of accurate patient information for insurance verification forms to designated vendors. Correctly determines place of care status for patients in nursing facilities. This position conducts insurance verifications and re-verifications to ensure billing and invoicing quality. This position also manages the complete life cycle of product returns, maintains organized invoice records, and uploads vendor invoice spreadsheets to the Hub and addresses any discrepancies. Helps to accurately manage tissue logs issues.

Essential Functions

• Accurately determines place of care/billing status of patients in nursing facilities.
• Manages tissue logs, correctly records applications per provider ensuring the correct serial numbers, dates of application and usage amounts are recorded.
• Submit accurate insurance, patient, and wound information to the appropriate vendor’s benefit verification team for all insurance verification forms within 24 hours of request.
• Conduct insurance verifications and re-verifications as needed to maintain high standards of billing and invoicing.
• Oversee the full life cycle of product returns, including completing necessary return forms, submitting them to vendors, and coordinating with vendors and providers to ensure they receive return labels.
• Provide precise return instructions based on vendor guidelines and maintain thorough records of all returns, including follow-up on unreceived products.
• Organize and maintain records of Organogenesis invoices, ensuring all relevant data is accurately recorded in billing trackers
• Upload vendor invoice spreadsheets to the Hub, identifying and troubleshooting any upload errors as necessary.
• Adapts to the evolving needs of the role by performing additional functions and tasks as required, ensuring flexibility and responsiveness to organizational demands.
• Perform other duties as assigned.
  
  

Utilization Review Coordinator Qualifications And Requirements

• High School Diploma preferred.
• Health Care and/or Wound Care Experience preferred.
• Experience in shipping and managing supplies in a supply chain is preferred.
• Experience in Medical Billing, Invoicing and Insurance Verification preferred.
• Proficient in Microsoft Office, especially Microsoft Excel
• Experience with an Electronic Medical Records and Electronic Medical Billing systems
• Strong analytical and problem-solving skills.
• Strong oral and written communication skills
• Strong organization and time management skills
• Ability to work independently.
• Ability to multi-task
• Strong critical reasoning, decision-making and problem-solving skills to analyze situations.
• Organizational skills and attention to details to handle multiple tasks, short deadlines, frequent interruptions, and shifting priorities in support of changing company objectives.
• Effective verbal and written communication including ability to present ideas and concepts effectively to providers, management, and other members of the team.
  
  

Physical Requirements

• Must be able to sit or stand at a computer for long periods of time and be able to call and discuss medical terminology.
  
  

Work Environment

• Hybrid, onsite office and home office.
  
  

Job Type: Full-time

Salary: $20.00 - $28.00/hour

Schedule

• Day shift
• Monday to Friday
  
  

Work Location: Sparks, MD

Healing Partners provides equal employment opportunities to all employees and applicants for employment without regard to race, color, ancestry, national origin, gender, sexual orientation, marital status, religion, age, disability, gender identity, results of genetic testing, or service in the military. Equal employment opportunity applies to all terms and conditions of employment, including hiring, placement, promotion, termination, layoff, recall, transfer, leave of absence, compensation, and training.