Utilization Review Coordinator
About The Position
Three Rivers Behavioral Health is a 136-bed treatment facility that specializes in quality behavioral health and substance abuse services for adolescents and adults. We offer a full continuum of care through an integrated system of inpatient, partial hospitalization and intensive outpatient programs. This position provides precertification and verification of benefits for incoming patients. It coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations/managed care companies. The role involves discussing various forms with patients and obtaining signatures, as well as completing insurance verification from various payors and obtaining correct information to complete precertification and appeals.
Requirements
- Masters’ degree in a recognized mental health field or Registered Nurse.
- Minimum of two years psychiatric experience in chart analysis and in the utilization review field.
- Excellent oral and written communication skills required in order to communicate in a clear and concise manner with patients, physicians, staff and payors.
- Knowledge of external review organizations, payor sources, financial planning and contracting (i.e., managed care, Medicare, Medicaid, etc.)
- Must be able to work in a fast-paced environment with frequent interruptions.
Responsibilities
- Provides precertification and verification of benefits for incoming patients.
- Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations/managed care companies.
- Discuss with patient various forms and obtain signatures from the patients.
- Complete insurance verification from various payors and obtain correct information to complete precertification as well as appeals.
Benefits
- Career development opportunities across UHS and our 300+ locations!
- Diverse programming to expand your experience
- Employee Assistance Program
- SoFi Student Loan Refinancing Program
- Employee Referral Program
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What This Job Offers
Career Level
Mid Level
