Utilization Review Coordinator

16 hours ago


Dunwoody, United States KGATLAMETSANG SOLUTIONS Full time
Job DescriptionSouthern Live Oak Wellness (SLOW), LLCis an evidence-based, client-centered treatment program that offers clients with all levels of need therapeutic interventions in an environment that is warm and welcoming. SLOW offers PHP, Day and evening IOP, and Residential treatment so that clients can receive care that meets them where they are at and helps them "Be the great person they were always meant to be." We are looking for Utilization Review Coordinators who thrive in a team-based, client-centric environment. Is this you? Read on

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

Preferred but not required:

Experience managing adolescent authorizations

Experience with Kipu EMR

Experience using online portals such as Availity, ICR, Webpass, etc.

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