Healthcare Utilization Review Expert

16 hours ago


Fort Worth, Texas, United States WellBridge Healthcare Full time

Responsibilities

  • Display knowledge of clinical criteria, managed care requirements for inpatient and outpatient authorization and advocate on behalf of the patient to secure coverage for needed services.
  • Complete pre and re-certifications for inpatient and outpatient services.
  • Report appropriate denial and authorization information to designated resources.
  • Actively communicate with interdisciplinary teams to acquire pertinent information and give updates on authorizations.
  • Participate in treatment teams to ensure staff have knowledge of coverage and collect information for communication with agencies.

Requirements

  • Bachelor's degree required; Master's degree preferred.
  • Previous utilization review experience in a psychiatric healthcare facility preferred.
  • Current unencumbered clinical license strongly preferred.
  • CPR certification and Crisis Prevention Training (CPI) preferred.


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