Utilization Specialist

UH Truman Medical Center is located in the Health Sciences District of downtown Kansas City, Missouri.The Health Sciences District represents a robust academic community, leading the forefront of biomedical research and cutting edge technology. Partnered with UMKC and Children's Mercy Hospital. University Health serves as the cornerstone in educating the next generation of healthcare practitioners. As a Level 1 Trauma Center, we're a leader in Emergency Medicine and Critical Care, with world-class expertise in chronic disease management and women's services, including high-risk maternity care. The Health Sciences District is also home to the University Health 1 and 2 buildings. UH 1 is UH's beautiful specialty outpatient clinics and day-surgery center and UH 2 is the location for all of our primary care and women's care clinics.

UH Lakewood Medical Center is located between Kansas City and Lee's Summit, Missouri, offering residents of Eastern Jackson County access to a modern community hospital with a continuum of outpatient services designed to meet the needs of families. UH Lakewood specializes in high-risk maternal and child care, and serves as one of the few Kansas City metro area institutions accredited by The Joint Commission in Orthopedics and Palliative Care.It also is home to a 188-bed, fully accredited long-term care center.

UH Behavioral Health is the KC metro area's largest, most comprehensive provider of mental health services. The Crossroads Building, located in Kansas City's vibrant Crossroads Arts District, is its epicenter, providing a broad list of outpatient services. We also offer psychiatric inpatient care, and we deliver therapeutic services through our community outreach clinics. We are a leader in the Trauma-Informed Care Movement, and provide training, coaching and consulting to outside organizations.

They will ask key questions to help facilitate the prior authorization and scheduling process for specified procedures and Admission Notifications. Utilization staff will need to work with FCC Staff for all self-pay patients to review eligibility for the University Health Discount and/or Medicaid. The Utilization Specialist will be expected to communicate financial responsibility to the patient and communicate with clinics and/or physicians with any concerns. In some clinic settings Patient Responsibility will be communicated by the scheduler.

The Utilization Specialist is responsible for facilitating the flow of information between the clinical areas, Utilization Management, insurance company and the Patient Accounting Department as well as documenting all pertinent information in Revenue Cycle through the Enhanced Authorization Process.

Minimum Requirements

• High school diploma or equivalent.

• Experience in healthcare insurance verification and billing protocols.

• Two years' experience in face to face and/or customer service or equivalent field.

• Working knowledge of medical terminology, CPT codes, and ICD9 codes.

• Ability to type 30 wpm.

• Communication and customer service skills required to gather and exchange information with patients, families, hospital staff members, physicians and third party payers.

• Ability to work and think independently with limited supervision, ability to handle sensitive information, with discretion, great attention to detail, ability to handle multi-tasking and change in priorities.

• Working knowledge and efficiency in Microsoft products (Outlook, Word, Excel, Access, & Power Point). Willing to become familiar with other software programs.

Preferred Qualifications

• Experience in Procedure Authorizations and Inpatient Admission Notifications

• Prior Experience working with Clinicians or Utilization Management

• Prior Experience in registration or working with insurance eligibility

• Course work in medical terminology and coding.