Novant Health

Utilization Review Support Specialist

Novant Health  •  Onsite  •  3 hours ago
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Job Description

Facility: SCR-ECH1 - East Cooper Medical Center

Locations: Mount Pleasant, South Carolina

Categories: Medical Records

Position Type: ['Full-Time']

Job Opening ID: ['185138']

What We Offer

  • Comprehensive benefits include medical, dental, vision, and life insurance.
  • Retirement fund with matching contributions.
  • Tuition assistance for qualifying team members.
  • Employee assistance programs and discounts.
  • Hybrid work opportunity.

What You'll Do

  • Schedule: Monday – Friday, daytime hours, rotating holidays.
  • Provide administrative and technical support to the Utilization Review team to ensure timely payer communication, authorization tracking, and accurate documentation.
  • Manage daily operations of the onsite Utilization Review (UR) office, including processing mail, answering phone inquiries, making calls to verify authorizations and denial determinations, and faxing communications for multiple facilities.
  • Process denials within a strict timeframe and manage payor work queues to avoid adverse determinations.
  • Facilitate EMR access by sending census reports to payors.
  • Process large volumes of confidential patient and payer information to support billing workflows (includes managing payor communications, processing authorizations, addressing denials, and indexing faxes).
  • Establish and maintain effective work relationships with both internal and external customers.
  • Maintain compliance and regulatory standards and organizational policies.

What We're Looking For

Required:

  • Education: High School Diploma or GED.
  • Experience: Minimum of one year of clerical and healthcare experience.
  • Additional Skills (required): Excellent interpersonal and customer service skills. Working knowledge of personal computers and software including specific knowledge of Microsoft office products. Perform clerical duties with accuracy. Proficient spelling and grammatical skills. Attention to detail with excellent planning and organizational skills. Communicate effectively in both oral and written forms. Keyboard/type accurately. Ability to operate standard office equipment including, but not limited to, a calculator, fax machine, copier, printer and scanner. Establish and maintain effective work relationships. Ability to successfully complete generic and department specific skills validation and competency testing.

Preferred:

  • Knowledge of Microsoft Office products with proficiency in Excel and Word.
  • Revenue cycle experience working with different payer types and working knowledge of their requirements.

Why Choose Novant Health?

At Novant Health, we believe remarkable care starts with compassion for our patients, our communities, and each other. We value belonging, courage, personal growth, and teamwork, creating a space where everyone is respected, supported, and safe to show up as their full selves.

Job Opening ID

185138

Novant Health

About Novant Health

Novant Health is an integrated network of more than 850 locations, including 19 hospitals, more than 700 physician clinics and urgent care centers, outpatient facilities, and imaging and pharmacy services. This network supports a seamless and personalized healthcare experience for communities in North Carolina and South Carolina. Novant Health is nationally recognized for our unwavering commitment to safety and the highest quality care, and we serve as a catalyst for healthcare transformation through clinical trials, leading-edge research, innovative care delivery models and robust virtual care networks. The expertise and empathy of our 40,000 team members along with more than 8,300 independent and employed clinicians are at the heart of Our Cause as industry leaders caring for communities across the Carolinas. In 2023, Novant Health provided more than $1.6 billion in community benefit, including financial assistance and services.

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Industry
Healthcare & Social Services
Company Size
10,000+ employees
Headquarters
Charlotte, NC
Year Founded
1997
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