Utilization Review Coordinator
16 hours ago
Job Description:
The Utilization Review Coordinator is a vital member of the SLOW Care component of the System of Care. The Utilization Review Coordinator is under the supervision of the Director of UR and is responsible for analyzing patient records to determine legitimacy of admission, treatment, and length of stay in a health-care facility to comply with government and insurance company reimbursement policies.
Location may vary
Pay Rate:$65,000 annually
Type: Full-time
Education:
High School Diploma/GED – AA degree preferred.
Current (five-years) of no felonies or substance abuse convictions.
Experience:
Must have two-years of continuous sobriety prior to hire, if a recovering alcoholic or drug addict and participate in a self-help program.
Knowledge And Training Required at Time of Hire:
- Familiar with American Society of Addiction Medicine (ASAM) and other insurance criteria scoringtools
- High familiarity withmedical necessity
- Experience managing mental health and substance authorizations for RTC, PHP, and IOP levels of care
- Ability to work with an interdisciplinary team
- Ability to multitask, work independently, and be proficientwith time management
- Experience scheduling peer reviews and coordinating with providers and their schedules
- Ability to answer phone calls, emails, and respond to voicemails in a timely manner
- Moderate working knowledge of psychiatric conditions, medical conditions, psychotropic medications, and reading lab/blood work results
- Ability to build and maintainrapport with clinicians, providers, and payers
Experience managing adolescent authorizations
Experience with Kipu EMR
Experience using online portals such as Availity, ICR, Webpass, etc.
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