UR Associate
2 weeks ago
The UR Associate role presents an exciting opportunity to start your path in advocating for client care in behavioral health facilities. This is the right position for you if you are passionate about helping those with MH/SUD and want to procure coverage for them. This role will bestow an opportunity to develop your interests in behavioral health, ensure client’s seeking help have coverage as long as needed, and learn medical necessity through ASAM and LOCUS criteria. You will ensure clients are getting MH/SUD treatment covered by insurance, build rapport with sites we service, communicate what is needed to secure authorization to clinical teams, develop conflict resolution, and build skills through research. This position comes with further career development as well as interesting and satisfying professional challenges.
Job Responsibilities
*Communicate with insurance companies to secure authorization for SUD/MH treatment.
*Become familiar with ASAM and LOCUS criteria.
*Strong and clear documentation when corresponding with insurance companies.
*Become accustomed to scheduling and completing peer reviews when able.
*Become familiar with insurance hold times, the types of submissions they require for authorization, and prioritize cases based on level of care/last covered day.
*Evaluate treatment outcomes and make recommendations for adjustments as needed based on medical necessity.
*Analyze data and documentation to ensure compliance with healthcare policies and regulations.
*Attend weekly meetings with assigned facilities to discuss status and medical necessity of cases.
*Abide by documentation guidelines and document EMRs and Monday clearly.
Job Skills & Qualifications
*High School Diploma
*Excellent time management skills
*Strong communication and conflict resolution skills
*Willingness to investigate and do research
*Strong documentation and written communication skills
*Strong focus on detail and accurate oral and written reporting
*Computer literacy and ability to learn new systems
Preferred
*Previous experience in the behavioral health/medical field
This position is open to in office, hybrid, or remote possibilities for the right candidate.
Benefits Include:
Medical, Dental, Vision, Life
Employee Assistance Program
401k Match
Paid-Time Off
Sick Time
Holiday Pay
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