Utilization Review Specialist

4 weeks ago


Orangeburg, United States Absolute Authorizations LLC Full time

Absolute Authorizations LLC provided pay rangeThis range is provided by Absolute Authorizations LLC. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.Base pay range$75,000.00/yr - $85,000.00/yrDirector of Operations @ Absolute AuthorizationsAbsolute Authorizations LLC is looking to hire an experienced healthcare clinician for our Utilization Review Specialist position. This is an in office position advocating patient care in Skilled Nursing Facilities.MANDATORY EXPERIENCE:Experience working with Skilled Nursing FacilitiesWorking knowledge reading clinical notesObtaining Authorizations for Skilled Nursing Facility careResponsibilitiesSubmit detailed concurrent reviews and appeals highlighting Medical NecessityProcure and maintain accurate tracking of all authorization and payer detailsIdentify and obtain reimbursement opportunitiesRoutinely correspond all outstanding billing details to FacilityProvide temporary coverage as neededCoordinate and streamline communication between Insurance Case Managers and Facility cliniciansServe as the primary point of contact and support for Facility staff addressing issues, questions, or concerns regarding their Managed Care population.QualificationsKnowledge of SNF Medicare and SNF Managed Care guidelinesKnowledge of SNF Managed Care policies, procedures and processes.Experience in a Skilled Nursing Facility setting (Rehab, Nursing, etc.)Valid medical license and clinical experienceExcellent verbal and written communication skillsOrganizational skillsKnowledgeable in Microsoft Suite and computer skillsBenefits401(k) matchingHealth insurancePaid time offJob Type: Full-timeSeniority level: Mid-Senior level #J-18808-Ljbffr



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