Utilization Review Specialist
2 weeks ago
The Utilization Review Specialist plays a critical role in optimizing reimbursement for the facility while ensuring quality of services provided and medical necessity. This position serves as a liaison between managed care organizations and the facility's professional clinical staff.
Key Responsibilities- Conduct reviews in accordance with certification requirements of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements.
- Inform clinical and medical staff of any specific concerns that would extend or restrict the length of stay of patients.
- Keep accurate records of all contact with external organizations and persons who have legitimate interest and legal access to information on the care of patients.
- Facilitate peer review calls between facility and external organizations.
- Act in coordination with the leadership team of the facility or corporate office to improve the quality of services provided within the organization.
- Assist the admissions department with pre-certifications of care.
- Initiate and complete the formal appeal process for denied admissions or continued stay.
- Provide ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates.
- Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office.
- Licensed LPN or RN, or Associate's Degree, Bachelor's Degree in Social Work, behavioral or mental health, nursing or other related health field; Master's degree in social work, counseling, nursing or related health field preferred.
- 2+ years' experience with the population of the facility and previous experience in utilization management preferred.
- Current licensure as an LPN or RN within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services.
-
Director of Utilization Review
3 weeks ago
Conway, Arkansas, United States Acadia Healthcare Full timeDirector of Utilization ReviewConway Behavioral Health is seeking an experienced Director of Utilization Review to lead the day-to-day operations of the Utilization Review department.Key Responsibilities:Monitor utilization of services and optimize reimbursement for the facility while maximizing use of the patient's provider benefits for their needs.Conducts...
-
Director of Utilization Review
4 weeks ago
Conway, Arkansas, United States Acadia Healthcare Full timeJob DescriptionAcadia Healthcare is seeking an experienced Director of Utilization Review to lead the day-to-day operations of the Utilization Review department.Key Responsibilities:Optimize Reimbursement and Resource Utilization: Monitor the utilization of services and optimize reimbursement for the facility while maximizing the use of patient...
-
Director of Utilization Review
2 weeks ago
Conway, Arkansas, United States Acadia Healthcare Full timeDirector of Utilization ReviewJob SummaryWe are seeking an experienced Director of Utilization Review to lead our Utilization Review department. The successful candidate will be responsible for directing and managing the day-to-day operations of the department, ensuring optimal reimbursement for the facility while maximizing use of patient benefits.Key...
-
Director of Utilization Review
4 weeks ago
Conway, Arkansas, United States Acadia Healthcare Inc. Full timeDirector of Utilization ReviewConway Behavioral Health is seeking an experienced Director of Utilization Review to lead the day-to-day operations of the Utilization Review department.Key Responsibilities:Monitor and optimize reimbursement for the facility while maximizing patient benefits.Conduct and oversee concurrent and retrospective reviews for all...
-
Director of Utilization Review
5 hours ago
Conway, Arkansas, United States Acadia Healthcare Full timeDirector of Utilization ReviewConway Behavioral Health is seeking an experienced Director of Utilization Review to lead the day-to-day operations of the Utilization Review department. The ideal candidate will have a strong background in clinical operations and a proven track record of optimizing reimbursement and maximizing patient benefits.Key...
-
Floor Maintenance Specialist
4 weeks ago
Conway, Arkansas, United States Compass Group Careers Full timeJob SummaryJob Title: Floor Maintenance SpecialistJob Summary: We are seeking a skilled Floor Maintenance Specialist to join our team at Compass Group Careers. As a Floor Maintenance Specialist, you will be responsible for maintaining, restoring, and operating industrial floor care equipment to ensure a clean and safe environment for our clients.Key...
-
Administrative Specialist II
3 days ago
Conway, Arkansas, United States State of South Carolina Full timeJob Title: Administrative Specialist IIWe are seeking an experienced Administrative Specialist II to join our team at the Department of Mental Health, Waccamaw Center for Mental Health. As an Administrative Specialist II, you will provide administrative support to our clinical staff, ensuring the smooth operation of our office.Key Responsibilities:Provide...
-
E-commerce Data Entry Specialist
2 weeks ago
Conway, Arkansas, United States Skutchi Designs Full timeE-commerce Data Entry Specialist Job DescriptionThis is a dynamic role that requires a keen eye for detail and strong organizational skills. As an E-commerce Data Entry Specialist, you will be responsible for processing orders, entering data into spreadsheets, and maintaining accurate records.Key Responsibilities:Process orders and enter them into our...
-
PSCN Receivables Specialist
2 weeks ago
Conway, Arkansas, United States Conway Regional Full timeJob SummaryWe are seeking a highly skilled PSCN Receivables Specialist to join our team at Conway Regional. As a key member of our revenue cycle team, you will be responsible for reviewing and resolving unpaid, underpaid, denied, or unresolved insurance balance accounts submitted to various health care payers.Key ResponsibilitiesReview and analyze insurance...
-
Automotive Paint Preparation Specialist
1 month ago
Conway, Arkansas, United States Robs Auto Body Full timeJob OverviewRobs Auto Body is seeking a skilled Automotive Paint Preparation Specialist to join our dynamic team. The ideal candidate will have a strong background in the automotive repair industry, specifically in paint preparation and finishing.Key ResponsibilitiesAssist in the preparation of vehicles for painting, ensuring all surfaces are properly sanded...
-
Orthopedic Nurse Specialist
3 weeks ago
Conway, Arkansas, United States Conway Regional Full timeJob SummaryWe are seeking a highly skilled Registered Nurse to join our team at Conway Regional. As an Orthopedic Nurse Specialist, you will play a critical role in providing exceptional patient care to our diverse population.Key ResponsibilitiesUtilize the nursing process to provide high-quality care to patients recovering from orthopedic and neurosurgery...
-
Financial Management Specialist
1 month ago
Conway, Arkansas, United States Workforce Connections, Arkansas Department of Commerce. Full timeJob SummaryWe are seeking a highly skilled Financial Management Specialist to join our team at Workforce Connections, Arkansas Department of Commerce. As a key member of our organization, you will be responsible for overseeing the financial management of our division, ensuring the accuracy and integrity of all financial transactions and records.Key...
-
Procurement Specialist
2 weeks ago
Conway, Arkansas, United States Arkansas Department of Workforce Services Full timeJob SummaryThe Procurement Specialist is responsible for procuring equipment, goods, and services in accordance with state and federal laws and agency/institution policy. This role involves formal and informal solicitations, building and maintaining vendor connections, pinpointing cost efficiencies and benefits for the University, and collaborating with...
-
Procurement Specialist
2 weeks ago
Conway, Arkansas, United States Workforce Connections, Arkansas Department of Commerce. Full timeJob SummaryThe Procurement Specialist will be responsible for procuring equipment, goods, and services in accordance with state and federal laws and agency/institution policy. This position will work closely with all University departments regarding their procurement needs and effectively communicate and train University faculty and staff on procurement...
-
Training to become a Scaffolding Specialist
4 weeks ago
Conway, Arkansas, United States Stellar Enterprises Full timeAbout the ApprenticeshipThis apprenticeship at Stellar Enterprises is a comprehensive training program designed to equip you with the skills and knowledge required to become a proficient scaffolding specialist.Key ResponsibilitiesLearn to plan, draw, and determine the necessary materials for scaffolding for various purposes in the industryParticipate in the...
-
Talent Acquisition Specialist
4 weeks ago
Conway, Arkansas, United States Workforce Connections, Arkansas Department of Commerce. Full timeJob SummaryWe are seeking a dynamic Talent Acquisition Specialist to join our team at Workforce Connections, Arkansas Department of Commerce. The ideal candidate will be responsible for screening, recruiting, and interviewing potential employees to support our organization's strategic talent acquisition efforts.Key ResponsibilitiesConduct full-cycle...
-
Facility Maintenance Specialist
3 weeks ago
Conway, Arkansas, United States S&D Coffee Inc Full timeJob SummaryWe are seeking a highly skilled and experienced Facility Maintenance Specialist to join our team at S&D Coffee Inc. As a key member of our maintenance team, you will be responsible for ensuring the smooth operation of our facilities and equipment.Key ResponsibilitiesSchedule and Prioritize Maintenance Work: Plan and execute daily maintenance tasks...
-
Refund Specialist
1 month ago
Conway, Arkansas, United States Conway Medical Center Full timeJob SummaryConway Medical Center is seeking a highly skilled Refund Specialist to join our team. As a Refund Specialist, you will be responsible for the complete credit balance, aged trial balance, as well as the investigation and resolution of the credit balance accounts for Provider Network Services.Key ResponsibilitiesInvestigate and resolve credit...
-
Ceramic Tile Specialist
1 month ago
Conway, Arkansas, United States House Doctors of Little Rock Full timePosition OverviewWe are seeking a skilled Ceramic Tile Specialist who is dedicated to delivering high-quality workmanship and exceptional client service. This role offers a competitive compensation package and the flexibility to manage your own schedule.What We Provide:Hourly pay ranging from $20 to $30, along with a vehicle allowanceFlexible working hours,...
-
Martial Arts Training Specialist
1 month ago
Conway, Arkansas, United States PMA CONWAY LLC Full timeJob OverviewThe Martial Arts Training Specialist at PMA CONWAY LLC is dedicated to transforming lives through engaging martial arts education. A vibrant and leadership-oriented individual is essential for this role. The ideal candidate will not only instruct but also motivate others to reach their fullest potential. A PMA instructor is committed to utilizing...