Medical Review Coordinator Position Available In Bucks, Pennsylvania

Bristol, PA
1 DAYS AGO
21553142
Summary
Bristol, PA
Competitive Salary
1 Years Experience
Bachelor’s degree
No Commisssion
40.00 hours per week / Day Shift /Full-Time
Description Medical Review Coordinator
Facility Lower Bucks Hospital
Location
US-PA-Bristol ID
2025-212194 Category
Business Professional Position Type
Full Time Shift
Days Job Type
Non-Exempt Overview Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Lower Bucks Hospital, a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference. Lower Bucks Hospital is a community hospital, serving the Lower Bucks County region with medical, surgical, and emergency care. Located in historic Bristol, Pennsylvania, the Hospital is well-known for its knowledgeable medical staff, including cardiology, orthopedics, radiology, wound care, and general surgery. The hospital has more than 200 physicians on staff, as well as another 700 employees. 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 Responsibilities Coordinates and completes the clinical reviews for all patient medical records while working closely with CMO (Chief Medical Officer). Actively participates in the Case management and UR meetings. Serves as on-going educator to all departments. Responsible for reviewing patient charts in order to assess whether the clinical 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 and Work Experience Required qualifications: 1. Master of Public Health (MPH) or post-graduation in a related health care field is required.
2. Medical Graduate, Dental Graduate required.
3. Knowledge of Clinical Pathophysiology and Pharmacology required.

Preferred qualifications:

1. ECFMG Certification And/or Bachelor’s or higher from a US-based accredited institution in a Health and Human Services field is highly preferred.
2. Utilization Review/Case Management experience is highly preferred.
3. 1+ year of clinical experience in acute care setting preferred.
4. Excellent written and verbal communication skills. Excellent critical thinking skills.
5. Excellent interpersonal skills to build effective partnering relationships with physicians, nurse staff, coding staff and hospital management staff.
6. Ability to work independently in a time-oriented environment.
7. Computer data entry with 10-key preferred, with accurate typing speed of 35 wpm preferred.
Employment Status Full Time Shift Days Connect With Us! Not ready to apply? Connect with us for general consideration. We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, sexual orientation, gender, gender identity, or other protected characteristics. If you need special accommodation for the application process, please contact

Human Resources:

hr-prime@primehealthcare.com