Utilization Review Assistant

4 days ago

Louisville, United States Acadia Healthcare Full time
Utilization Review Assistant

Full-Time

Village Behavioral Health is a psychiatric residential treatment center that offers a full spectrum of treatment options for children and adolescents ages 10-17. A uniqueness of Village Behavioral Health is that we use nature as part of our therapeutic process. We are nestled in Louisville, TN right on the Tennessee River spread out over 65 wooded acres.

Pay Range: $15 to $20/hour depending on education level and experience

Schedule: Office hours Monday-Friday

Benefits:

  • Growth opportunities
  • Competitive hourly rates
  • Free breakfast, lunch and dinner while on shift
  • Handle with Care Training
  • CPR Training
  • Medical, Dental, and Vision Insurance
  • Paid Holidays
  • Paid Time Off
  • 401(k) Retirement Plan - with company match
  • Employee Assistance Program/Employee Discount Program
Responsibilities:

•Perform pre-certification, clinical case information and negotiate continued stay with third party payers.
•Gather data to support case management activities, including presentation of gathered data and case notes.
•Assist physician in peer review by serving as information resource, gather data to support review and schedule peer review.
•Informs management about the status of current patients; documents utilization activities as instructed. Participates in performance improvement activities.•Monitor patient length of stay and extensions as well as notifying clinical staff on issues
that may arise.
•Initiate and complete formal appeal process for denial of continued stay.
•Notify business office of any uncovered days such as the result of a peer review and/or
appeal.
•Communicate with treatment team and families effectively so that there is a smooth
transition between the time an insurance company denies continue stay and the time the
parent has to discharge the child.
•Enter all insurance authorizations and extensions into HMS along with details, if apply.
•Download, print and scan all authorization confirmation sheets into HMS.•Conduct quality reviews of patient charts for medical necessity and services provided set
forth by insurance plans or other managed care organizations.

Requirements:
  • High school diploma or equivalent required.
  • Current certification as Registered Addiction Specialist, certified Substance Abuse Counselor or similar certification preferred.
  • Valid driver's license required.
    Must pass pre-employment drug screen, 7-year criminal background screen, fingerprint screen, MVR screen, work history and reference check.


Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)

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