We’re a Good Family to Know:

Preferred Family Healthcare (PFH) is a community-based healthcare organization that offers a full array of integrated services, serving more than 100,000 individuals each year in nearly 100 locations throughout Missouri, Oklahoma, Kansas and Illinois.

Our greatest reward has been the opportunity to serve families and communities in need for the past 40 years. At PFH, our future is brighter than ever! With changes in leadership, focused priorities and strong core values, PFH remains a “Good Family to Know!”

Your role at PFH:

As a Utilization Review Coordinator, you are responsible for supporting the third party reimbursement functions including working with sites during the admission process by providing verification of insurance, obtaining and relaying clinical information to and from staff and third-party payers in an effort to obtain authorizations and continued stay reviews, as well as assisting with billing inquiries. You will:

• Audit/monitor intake appointments for clients with third party insurance, managed care Medicaid, and/or private pay clients and be available to offer assistance as needed.
• Complete benefit verification as soon as insurance information is received. Document in electronic medical records system and alert clinical team of any concerns, limitations, or extraordinary service requirements which may require additional clinical services or an individualized schedule for that client.
• Utilizes completed Initial Review Screening form information to seek pre-authorization for insurance-based clients. Communicate the pre-authorization determination to the clinical team and explain ramifications if care was denied, documenting in the electronic medical records system.
• Consult with clinical staff prior to follow up contact with insurance companies and work with insurance representatives on continued stay authorizations, keeping staff apprised of changes in insurance status/benefits at all times.
• At the time of admission, confirm that admission staff has received a copy of client insurance card(s).
• Track client authorizations, denials, admissions, discharges, and other important information and provide a weekly report to supervisor, billing, and other appropriate staff.

We think you’d be great for this role if you have:

• Bachelor’s Degree in Counseling, Social Work, Healthcare Management, Business Admin or Medical Billing preferred.
• Five-years-experience in a healthcare or insurance setting preferred.

You’ll love being a part of our family because:

Our associates are our most valuable asset! We understand the role their satisfaction plays in the quality of services they provide. Through encouragement, our associates are empowered to optimize their strengths through ongoing training to ensure they are equipped and feel competent to serve our clients.

Our eligible associates enjoy some of the following PFH Perks:

• Comprehensive medical, dental, vision, life insurance and disability plan options
• Competitive 401(k) Retirement Savings Plan – up to 5% match!
• Company paid basic life insurance
• Paid Time Off Program for vacation, holiday and sick time
• Emergency Medical Leave Program
• Flexible Spending Accounts – healthcare and dependent child-care
• Health & Wellness Program
• Employee Assistance Program (EAP)
• Employee Discount Program
• Mileage Reimbursement
• License/Certification Reimbursement

Our human resources team wants to let you know what’s required:

Employment is conditional upon the receipt of appropriate background checks. Upon offer of employment, you must grant permission for Preferred Family Healthcare to verify accuracy, legitimacy, and results in regards to the following conditions of employment:

• Background check that includes criminal history and abuse/ neglect.
• Motor vehicle driving record check.
• Education and license/certification verification (if applicable).
• Employment and/or personal reference checks.