UR Specialist
2 months ago
A Utilization Review Specialist’s responsibilities include but are not limited to completing all medical necessity reviews with payer on the facility’s behalf and documenting outcomes in the facility’s EMR (Alleva/KIPU), While communicating to our own team at CRS internally in Monday. In addition, the best candidate for this position will be experienced in behavioral health commercial payer medical necessity criteria. A Utilization Review Specialist will follow the company's process for requesting authorization from insurance providers. A Utilization Review Specialist will also be responsible for following up on all pending/outstanding dates of service with no authorization.
Requirements: Minimum Requirements:
*High School Diploma
*Excellent time management skills
*Strong written/verbal communication
*Conflict resolution skills
*Willingness to investigate and do research
*Strong focus on detail and accurate oral/written reporting
*Open-mindedness to training and feedback
Preferred Requirements:
*Previous experience in the behavioral health/medical field
*Computer literacy and ability to learn new systems
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