Overview Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Garden City Hospital, a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference. At Garden City Hospital, we pride ourselves on community involvement and commitment to preserving access to quality and compassionate healthcare. We are a state-of-the-art medical facility with over 300 licensed beds and a teaching hospital, offering medical education to students, residents and fellows from across the country. The residency and fellowship programs offer graduate medical education to more than 80 trainees in specialties. Garden City Hospital has an award-winning staff of over 350 of the area's best and brightest physicians from almost every specialty. Learn more atwww.gch.org. Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC\_KnowYourRights\_screen\_reader\_10\_20.pdf Responsibilities The Utilization review tech essentially works to coordinate the utilization review and appeals process as part of the denial management initiatives. Utilization review tech is responsible for coordinating phone calls, data entry and tracking data from various insurance providers and health plans regarding authorization, expedited reviews and appeals. Document and track all communication attempts with insurance providers and health plans. Utilization review tech will follow up on all denials while working closely with the Corporate/Facility Utilization review teams, Business Office and Case Managers. The Utilization review tech will also serve as the primary contact and coordinate the work to maintain integrity of tracking government review audits (RAC, MAC, CERT, ADR, Pre/Post Probes, QIO/Medicaid) and other payer audits as assigned. The Utilization review tech will further support the department needs for Release of Information, discharge coordination or other duties as assigned. Qualifications Education and Work Experience 1. Bachelor’s degree or four years of relevant experience required.2. Accurate alphabetic, numeric, and/or terminal-digit filing skills.3. Computer data entry with 10-key, with accurate typing speed of 35 wpm required. Excel skills highly preferred.4. Knowledge of terminal digit filing and medical terminology; preferred.5. Knowledge of State and Federal regulatory requirements for medical staff documentation; preferred.6. Completion of a medical terminology course; preferred.7. Background in business and office training; preferred. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/185823/utilization-review-tech-iii---gch/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityGarden City Hospital LocationUS-MI-Garden City ID2024-185823 CategoryBusiness Professional Position TypeFull Time ShiftDays Job TypeNon-Exempt