Coordinator, Resource Management (FT- Brunswick Campus)

Interested in working for the Golden Isles’ healthcare provider and employer of choice?

Throughout the many locations that make up the Southeast Georgia Health System network, there is a common thread that pulls everything together: A team of committed professionals like you. These individuals appreciate the value of every person who walks through our doors, and are the key to our culture of Service Excellence.

As a Resource Management Coordinator, you will conduct medical record reviews of all denied inpatient and/or observation encounters. You will function as an administrative assistant as needed by the department Manager and/or Director. For our team members, this is more than a career — it’s a calling.

You will be responsible for:

• Coordinates concurrent and retro precertification processes.
• Assesses payer denials for appropriateness of appeal and initiates the appeal process in a timely manner. Demonstrates proficiency in preparation and follow-up of denial appeals. Maintains denial spreadsheet report-keeps it current & accurate by payer. Works congenially with Patient Financial Services department to ensure open & thorough communication.
• Maintains ongoing knowledge of payer compliance issues and has the ability to convey same to physicians/office staff.
• Assists the Manager with validating that utilization review processes are conducted as outlined in the Utilization Plan.
• Coordinates patient’s appeals to the Quality Improvement Organization (QIO) ensuring timely medical record submission and tracking of QIO decision.
• Responsible for data compilation regarding length-of-stay, avoidable days and readmissions, and the preparation of appropriate statistical information for dissemination to physicians, Quality Management, Health Information Management and Administration.
• Serves as point of contact for all alternate language/communication needs within Health System – assists with accessing services as needed; maintains records of LEP equipment location.
• Maintains time & attendance and PTO requests as approved by department Manager; Assists Case Managers in obtaining DME; Scans paper documentation into patient’s electronic medical record as needed. Other responsibilities as assigned.

Job Requirements: