Utilization Review Specialist
2 weeks ago
GulfSouth Autism Center provides individual treatment plans for children ranging in ages from toddler to preschool that are diagnosed with autism spectrum disorder. Our on-site BCBAs provide individual and group ABA Therapy and our Allied Health team focuses on Speech Therapy as well as Occupational Therapy. GulfSouth therapy is primarily 1:1 teaching children skills such as social interactions, language communication and social development.
The Utilization Review Specialist Oversees:
- Oversee daily Operations and the work of GSAC administrative employees.
- Maintains quality control among all GSAC administrative employees.
- Is part of annual strategic planning.
- Manages Autism Center Waitlists, timelines, and clinical operations.
- Monitor client discharges and outcomes
Financial
- Monitor billing vs income for Allied Health
- Monitors billing vs income for all GSAC locations/providers.
- Works closely with collections department and assists with billing and collections, when needed.
- Oversight of Billing Compliance System.
Compliance
- Assisting Operations Team with analyzing and updating existing compliance policies and related documentation.
- Communicating compliance policies and guidelines to Management and designated departments.
- Developing and executing new compliance policies and procedures as required.
- Performing Daily internal auditing and compliance checks with our clinics using Catalyst System.
- Developing and maintaining a compliance recordkeeping system.
- Assisting with the training of employees on industry compliance requirements.
- Keeping up with compliance requirements and amendments to regulations.
Requirements:
- Bachelor's degree in business administration or accounting preferred
- In-depth knowledge of industry compliance requirements and standards.
- Experience with Microsoft Office
- Exceptional ability to formulate compliance policies, procedures, and related documentation.
- Advanced analytical abilities.
- Effective research and professional networking skills.
- Ability to effectively train employees.
- Strong leadership and communication skills
- Exceptional communication and interpersonal skills.
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