UR Specialist- Utilization Review
Job Summary: Responsible for coordination of the day to day insurance related activities and provides direct support to the Utilization Review Department
About CarolinaEast Health System
CarolinaEast Health System is committed to providing high quality, compassionate care across the Coastal Carolina region. At the heart of our system is a 350-bed, full-service medical center equipped with a comprehensive range of inpatient and outpatient services, utilizing the latest medical technologies. We employ over 3,200 dedicated team members and operate physician practices across various specialties in four counties. Our employees foster a culture of excellence that ensures our patients receive the same high level of care found at larger medical centers, all while maintaining a friendly, community-centered atmosphere throughout our facilities. CarolinaEast offers a robust benefits package to all full-time employees, as well as benefits for part-time plus and part-time staff. We are proud to be the first medical center in North Carolina recognized as a Cardiovascular Center of Excellence by the American College of Cardiology and the American Heart Association. Additionally, we are honored to be named one of America’s Best-In-State Hospitals by Newsweek, among numerous other prestigious accolades.
Minimum Requirements:
- High School Diploma or higher degree required
- Three to five years’ experience of pre-cert, utilization review, denial/appeals or billing
- Knowledge of APC coding and DRGs preferred
- Proficiency in Microsoft Office applications including Excel, PowerPoint and Word
- Excellent verbal and written communication skills
- Deliver outstanding customer service that upholds CarolinaEast's Standards of Excellence.