Utilization Review Coordinator - Day Shift

The main responsibilities of a Utilization Review Coordinator at Desert Parkway include ensuring all initial authorizations are properly initiated with the appropriate payor, documenting required notes, and verifying this information on payor websites. Daily tasks also involve retrieving discharge documents from patient charts, managing UR metro fax communications, and maintaining an updated denial tracker for appeals.

To qualify for the Utilization Review Coordinator position at Desert Parkway, you need at least a high school diploma or GED, with two years of healthcare experience preferred. Knowledge of Nevada payors is essential, as well as strong skills in Microsoft Word and Excel to manage documentation and daily reports effectively.

As a Utilization Review Coordinator at Desert Parkway, you will be eligible for a range of competitive benefits starting from the first of the month following 30 days of employment. These include health, vision, and dental insurance, a 401K retirement plan, PTO with holiday premium pay, and both short- and long-term disability plans, among others.

The Utilization Review Coordinator plays a critical role in patient care at Desert Parkway by ensuring that all necessary authorizations are obtained in a timely manner, which is essential for facilitating smooth discharge processes and ensuring that patients receive the care they need without unnecessary delays.

A typical day for a Utilization Review Coordinator at Desert Parkway involves running morning reports, retrieving daily discharge documents, managing fax communications, and updating necessary documentation in the case management system. This role requires multi-tasking and involves close attention to detail to ensure compliance with payor requirements.

In your response, emphasize any previous roles where you managed authorizations, detailing the processes you used to ensure timely submissions and your understanding of payor requirements.

Share your methodology for prioritizing tasks, mentioning the use of daily checklists or reports. You could give an example of how you handle urgent authorizations versus routine document retrievals.

Discuss your proficiency with tools like Microsoft Word and Excel, as well as any other healthcare management software you’ve used. Provide examples of how these tools help you organize and track documentation.

Explain the importance of confidentiality and detail the practices you follow to ensure patient information is safeguarded, such as secure handling of documents and compliance with regulations.

Discuss a specific situation that highlights your problem-solving and communication skills. Focus on what action you took and what the outcome was, demonstrating your ability to manage challenges effectively.

Share information about resources you follow, such as industry publications or training sessions, and how staying updated impacts your work as a Utilization Review Coordinator.

Describe your approach to investigating discrepancies, emphasizing the importance of careful review and communication with both internal teams and external payors to resolve issues promptly.

Think of a specific project or task where your contributions played a key role in the team achieving its goals, illustrating teamwork and collaboration in your response.

Here, you can discuss techniques you use for organization, such as time-blocking or software tools, and how these have helped you manage workloads effectively without sacrificing attention to detail.

Illustrate your analytical skills by explaining how you would track and analyze the data, collaborate with your team to identify root causes, and develop strategies for addressing and improving the situation.