Texas Health Resources Clinical Review Specialist-Part Time-Arlington in Arlington, Texas
Texas Health System Services seeks to hire a Clinical Review Specialist to work Part Time at the offices located in the Chase Bank building in Arlington.
The address is 500 East Border Street, Arlington, TX 76010
Salary range is Min $14.36 – Max $21.74 – based on relevant experience
Part Time 16 hours per week
Saturdays and Sundays 8am-4:30pm
Must be able to attend two week training Mon-Fri 8am-5pm before starting the part time hours
Responsible for coordinating the clerical and administrative processes of utilization management/ denials
Responsible for managing central fax / email accounts (Central Repository)
Responsible for managing requests submitted from payors around discharge dates and appeals
Responsible for completing any other tasks within department guidelines requested by UM RN or Denials and Appeals RN
Faxes clinical reviews to payers
Obtains and enters authorization numbers from payers
Performs inquiries for benefits and eligibility
Provides discharge dates to payers
Faxes, copies as needed for UM activities
Supports denials and appeals processes
Collects/enters data as directed and performs other administrative duties (as needed)
Supports utilization management/ denials and appeals activities under the direction of the UM RN or Denials and Appeals RN:
Forward to payer (OBTAINS review from UM RN with criteria supporting admission/continued stay.
Keywords: “Abstractor” “Abstracting”
The ideal candidate will possess the following qualifications:
High School Diploma or equivalent required
One year of relevant experience, preferably in a healthcare or service environment required
Knowledge of medical terminology required.
Requires problem solving skills although most information is well-defined and minimal clarification is necessary. Specific projects and goals are assigned with latitude for decision making and setting of priorities. Supervision is readily available and work may be checked for accuracy.
Ability to work with minimal supervision. Requires interpersonal skills, communication skills, and the ability to work without supervision when necessary.
Proficient computer skills with experience in: MS Office, internet navigation, clinically-based software, and financially-based software.
Why Texas Health Resources?
Texas Health Resources is one of the largest faith-based, nonprofit health care delivery systems in the United States and the largest in North Texas in terms of patients served.
Texas Health has 25 acute-care and short-stay hospitals that are owned, operated, joint-ventured or affiliated with the system. It has more than 3,800 licensed beds, more than 21,100 employees of fully-owned/operated facilities plus 1,400 employees of consolidated joint ventures and counts more than 5,500 physicians with active staff privileges at its hospitals.
At Texas Health, we strive to create an atmosphere of respect, integrity, compassion and excellence for all who come in contact with us, be they patients or our employees. We are committed to diversity in our workforce, and our mission to serve spreads across ethnic, cultural, economic and generational boundaries. We invite you to join us in furthering your career through our accomplishments and philosophy of excellence.
Texas Health Highlights
• 2018 FORTUNE Magazine’s “100 Best Companies to Work For®” (4 th year in a row)
• 2018 Becker's Healthcare "150 Great Places to Work in Healthcare" (4 th year in a row)
• 2018 Employees’ Choice “Best Places to Work” by Glassdoor
Employment opportunities are only reflective of wholly owned Texas Health Resources entities.
We are an Equal Opportunity Employer and do not discriminate against any employees or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.