UR COORDINATOR

UHS•Titusville, FL

8d•Onsite

About The Position

Palm Point Behavioral Health (affiliated with Universal Health Services) is a 74-bed behavioral health hospital located in Titusville, Florida. Palm Point Behavioral Health treats adults, children, and adolescents suffering from a wide range of behavioral health diagnoses, including depression, anxiety, and substance abuse. The facility offers inpatient treatment options and serves communities in Brevard County and beyond. The UR Coordinator monitors and coordinates appropriate documentation and utilization of services throughout the course of treatment for patients admitted to the inpatient and outpatient program and coordinates authorization for third-party payors. The UR Coordinator also reviews cases for appropriateness of admission, continued stay, and discharge planning. They assist in the promotion and maintenance of high-quality patient care through review and evaluation of clinical practices. The UR Coordinator will attend treatment team meetings and provide communication based on documentation and verbal exchange regarding treatment. The UR Coordinator will communicate with external entities to facilitate the acquisition of resources. The Utilization Review Coordinator is responsible for monitoring and completing appeals and retrospective reviews for patients. Ensures appeals are sent out timely and assists the Utilization Review Manager with other duties assigned.

Requirements

Associate Degree in Nursing or Bachelor's Degree in social work, mental health or related field from accredited college or university required.
A minimum of two (2) years’ experience in health care case management or utilization review, psychiatric or mental health setting required.
Current, Valid State License (RN, LCSW, LMHC, or LMFT) Preferred.

Responsibilities

Review clinical content of medical records, participate in treatment team meetings, and collaborate with physicians, therapists, nurses, and pertinent staff on gathering the necessary data to communicate with insurance companies/authorizing entities to ensure initial precertification and continued authorization is achieved.
Ensure input of pre-certifications and continued stay reviews into Midas, follow-up on unfinished pre-certifications from the day before, coordinate with the treatment team on any follow-ups necessary, verify insurance coverage at the first of the month, and post patient payments into MS4.
Trained in all aspects relative to timely gathering of clinical criteria, communication of clinical criteria, and entry of supporting clinical criteria into computer-based systems, in addition to other job duties.