Coordinator, Office Utilization Review (FT, Days) Monterey Park Hospital

Overview

Monterey Park Hospital, a 101-acute care facility located in the San Gabriel Valley of Los Angeles County, is seeking an Office Coordinator for our Utilization Review Department . This is a full-time, 8-hour day shift position reporting to the Chief Operating Officer.

Responsibilities

The Utilization Review (UR) Office Coordinator is responsible for administrative duties and for assisting case managers with the daily operations of the department. The UR Office Coordinator processes all new patient admissions by preparing case reviews, including patient insurance information, for our Case Managers. The UR Office Coordinator prints the daily census to ensure proper caseload distribution and prepares Treatment Authorization Requests (TARs) for all medical inpatients as required. Additional responsibilities include:

• Preparing, logging and faxing all TARS according to hospital guidelines, including notifying physicians of medical denials, processing deferred TARS, communicating with a medical nurse reviewer and making copies of medical documents for TAR review.
• Communicates with IPAs and management companies regarding out-of-network capitated business and documents all communications.
• Assists in collecting data relevant to patient discharge and helps coordinate nursing facility placements as directed by the Case Managers.
• Performs other clerical duties as needed within the department, including answering and screening phone calls and taking department meeting minutes.
• Communicates via phone with health plan/medical group case managers/coordinators regarding discharge planning and coordination.
• Arranges outpatient follow-up appointments for patients prior to discharge when needed.
• Assists in arranging hospice referrals, home health referrals, and durable medical equipment (DME).
• Coordinates ambulance transportation for patient discharges.

Qualifications

• Knowledge in Google Workspace (Docs, Sheets, etc.) preferred.
• 2 years of experience in an acute care setting (i.e., Admitting, Medical Records, Business Office) preferred.