Medical Review Coordinator I

Prime Healthcare • Elgin, IL • 4h ago

Responsibilities

Coordinates and reviews all medical records, as assigned to caseload. Actively participates in Case Management and Treatment Team meetings. Serves as on-going educator to all departments. Responsible for reviewing patient charts in order to assess whether the criteria for admission and continuation of treatment is being met; gathering data and responding to request for records from payers/fiscal intermediary etc.; gathering clinical and fiscal information and communicating status of both open and closed accounts for multiple levels of Utilization Review and Case Management reporting. Able to work independently and use sound judgment. Knowledge of Federal, State, and intermediary guidelines related to inpatient, acute care hospitalization, as well as lower levels of care for the continuity of treatment. Coordinates discharge referrals as requested by clinical staff, fiscal intermediary, patients, and families. Performs other duties as assigned.

Qualifications

EDUCATION, EXPERIENCE, TRAINING

Required qualifications:

Medical Graduate, Dental Graduate, PA, or Nursing Graduate required.

Preferred qualifications:

ECFMG Certification And/or Bachelor's or higher from a US-based accredited institution in a Health and Human Services field is highly preferred. Utilization Review experience is highly preferred. Clinical experience in acute care setting preferred. Excellent written and verbal communication skills. Excellent critical thinking skills. Excellent interpersonal skills to build effective partnering relationships with physicians, nurse staff, coding staff and hospital management staff. Ability to work independently in a time-oriented environment

Pay Transparency

Saint Joseph Hospital - Elgin offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $32.00 to $46.35. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

The company is dedicated to empowering its staff with a comprehensive, competitive benefits package, allowing them the freedom to customize their benefits to fit their unique needs. Our abundant resources, programs, and voluntary options serve as a foundation for individual growth and well-being. Learn more here:https://www.primehealthcare.com/benefitsthatmattermost/

Employment Status

Full Time

Shift

Days

Equal Employment Opportunity

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

LI-ME1

Need help finding the right job?

We can recommend jobs specifically for you!

https://click.appcast.io/pixels/icims-25851.js?ent=417&jsid=$T{Submittal}.$T{Person}.$F{PersonID}script>

FacilitySaint Joseph Hospital - Elgin

LocationUS-IL-Elgin

ID2026-264127

CategoryBusiness Professional

Position TypeFull Time

ShiftDays

Job TypeNon-Exempt

Similar Jobs

Registered Nurse - Float

Prime Healthcare • Aurora, IL • 2h ago

Hospital & Medical

Bonus Amount `10,000 Bonus Information Sign-On Bonus Available for Qualified Candidates. Eligibility and payout terms apply. Details discussed during the interview process. Overview Department: Nursing Float Schedule: Fu...

2h ago

Go to Apply

New Graduate Registered Nurse

Prime Healthcare • Elgin, IL • 2h ago

Hospital & Medical

Responsibilities The Registered Nurse is responsible for the delivery of safe patient care utilizing the nursing process of assessment, planning, implementation and evaluation. Provides direct patient care within the sco...

2h ago

Go to Apply

Registered Nurse-RN

Trinity Health • Maywood, IL • 2h ago

Hospital & Medical

Employment Type: Full time Shift: Description: Ambulatory Registered Nurse for the Breast Clinic This position will support multiple locations Monday - Friday We are seeking a Registered Nurses (RNs) who are dedicated to...

2h ago

Go to Apply

Medical Assistant

CVS Health • Bellwood, IL • 3h ago

Hospital & Medical

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate...

3h ago

Go to Apply

Physical Therapist / PT

Aegis Therapies • Glenview, IL • 6h ago

Hospital & Medical

Physical Therapist / PT - CCRC: Full-time A Continuing Care Retirement Community (CCRC) offering a diverse setting with a wide range of treatment opportunities throughout the continuum of care. ? Job Type: Full-time Sche...

6h ago

Go to Apply

Home Health Physical Therapist

CenterWell • Buffalo Grove, IL • 6h ago

Hospital & Medical

Become a part of our caring community As a therapist at CenterWell Home Health, reporting to the Clinical Manager, you will help patients regain strength, mobility and independence, from the comfort of their homes. By de...

6h ago

Go to Apply

Home Health Physical Therapist Assistant

CenterWell • Buffalo Grove, IL • 6h ago

Hospital & Medical

6h ago

Go to Apply

Gibson Electric Co., Inc. - Information Technology Business Systems Analyst

EMCOR Group • Downers Grove, IL • 19h ago

Hospital & Medical

About Us We are an electrical construction firm specializing in commercial electrical and telecommunication infrastructure design, structured cabling installation and maintenance, electrical power distribution systems, d...

19h ago

Go to Apply

Home Health Account Executive

CenterWell • Pingree Grove, IL • 1d ago

Hospital & Medical

Become a part of our caring community As a Home Health Account Executive , you will: · Call on physicians, hospitals, SNF management, discharge planners, and case managers within an assigned territory to promote our home...

1d ago

Go to Apply

Pharmacy Operations Manager

Walgreens • Huntley, IL • 1d ago

Hospital & Medical

Job Description: Where state and federal laws/regulations allow, accountable for performing day-to-day non-clinical pharmacy operations, administrative activities; Ensures efficient pharmacy workflow and a positive patie...

1d ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)