You haven't searched anything yet.
Pinnacol Assurance does just one thing, and does it better than anyone: provide caring workers’ compensation protection to Colorado employers and employees. And while we may be a little biased, we believe that our work shapes communities and changes lives.
We have big hearts and love big ideas. We’ve been around for more than 100 years, but don’t let that fool you. Pinnacol is committed to taking care of Colorado employers and workers in the most innovative ways. We celebrate continuous improvement, new ideas, compassion, teamwork, integrity and excellence.
With our number one priority to keep everyone safe, along with the heart of Pinnacol’s “culture of caring” to do what is right and not what is easy, we’re currently having our team members work from home. But we’re still making time for fun with virtual events like virtual painting classes, virtual yoga and Zumba classes, and virtual happy hours!
What you’ll do:
Responsible for helping to establish a new utilization review (UR) department within Pinnacol. Key areas of focus include carrying out reviews of medical records and prior authorization requests to determine the clinical necessity and appropriateness of medical services that have been requested or previously furnished. To inform these reviews, follows standardized protocols informed by evidence-based guidelines and similar literature. Communicates with community medical providers to request information and provide education. Shares pertinent information with independent physician advisors who make final payment (coverage) determinations. Communicates with injured workers about coverage decisions. Collaborates with bill pay processors to ensure that approved and denied services are paid appropriately. Collaborates as needed with medical nurse case managers, claims adjustors, and other internal and external stakeholders. Supports and participates in a transition towards increasing UR efficiency and automation by taking advantage of new software that streamlines workflows and helps manage information and communication.
What you can expect:
Additional Duties:
What you need to be successful:
When we find the right person, we try to put our best foot forward with an offer that excites you. We consider what you’d like to be paid, the skills and experience you bring, what similar jobs pay in the Denver area and make sure there’s equal pay for equal work among those you’ll be working with. The compensation amount for this role is targeted at $49,700-$53,700/yr. Final offer amounts are determined by multiple factors including your experience and expertise and may vary from the amounts listed above.
Want to love your work? Apply today!
Pinnacol is committed to working with and providing reasonable accommodations to applicants with disabilities. To request assistance with the application process, please email recruiting_team@pinnacol.com.
This posting will close 15 days from after being published. It is scheduled to close on March 11th, 2024.
Full Time
Insurance
$81k-100k (estimate)
02/29/2024
04/28/2024
pinnacol.com
DENVER, CO
500 - 1,000
1915
Private
PHIL KALIN
$200M - $500M
Insurance
Pinnacol is a provider of workers' compensation insurance solutions in Colorado.
The job skills required for Utilization Review Coordinator include Health Care, Teamwork, Flexibility, etc. Having related job skills and expertise will give you an advantage when applying to be an Utilization Review Coordinator. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Utilization Review Coordinator. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Utilization Review Coordinator positions, which can be used as a reference in future career path planning. As an Utilization Review Coordinator, it can be promoted into senior positions as a Clinical Outcomes Manager that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Utilization Review Coordinator. You can explore the career advancement for an Utilization Review Coordinator below and select your interested title to get hiring information.