ApplyBlast uses AI to match you with the right jobs, tailor your resume and cover letter, and apply automatically so you can land your dream job faster.

Features

Auto Apply Resume Optimizer Cover Letter Optimizer Interview Prep

Company

Social Media

Need Help?

team@applyblast.com

Utilization Review Specialist at St. Charles Health System, Inc. - ApplyBlast

Utilization Review Specialist

St. Charles Health System, Inc.

4 months ago

Bend, OR

Onsite

Part Time

Junior

0 applicants

View Job Listing

Apply to 100+ jobs

About this role

A Utilization Review Specialist at St. Charles Health System verifies benefits, procures authorizations, and collaborates with interdisciplinary teams to ensure medical necessity and appropriate service utilization. The role involves managing payor communications, supporting clinical denials and appeals, and maintaining compliance with federal and state regulatory requirements.

Responsibilities

Verify benefits and procure prior authorizations for patient admissions
Collaborate with interdisciplinary teams to ensure medical necessity compliance
Support clinical denials and appeals processes for concurrent and post claims
Submit clinical reviews and authorization information to payors
Maintain knowledge of UM regulations and prepare regulatory notices

Skills

Qualifications

Associate degree in Health Information ManagementCurrent RHIT certification

About St. Charles Health System, Inc.

stcharleshealthcare.org

Headquarters

Oregon, United States

Company Size

1001-5000 employees

Founded

1918

View Profile

St. Charles Health System is a regional healthcare organization based in Oregon, providing a comprehensive range of medical services including emergency medicine, primary care, cardiology, oncology, behavioral health, and women's health. The health system operates multiple hospitals, urgent care centers, and outpatient facilities, serving communities across Central Oregon. Patients can access care through in-person visits, virtual visits, and the MyChart online portal for managing medical records and appointments.