Utilization Review Coordinator

UHS•West Columbia, SC

65d

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. Conveniently located between I-20 (Exit 61) and I-26 (Exit 110) in West Columbia, SC, our team of 300+ high quality employees describe working here as " family atmosphere," "supportive leadership," and "life-changing." Progressive professionals in the fields of psychiatry, medicine, nursing, social services, and activity therapy serve hundreds of adults and adolescents each month with the common goal of creating new beginnings. Healthcare professionals have a unique opportunity to affect lives for the better each and every day. Choose Three Rivers and start your life-changing journey today. Job Duties/Responsibilities: This position 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. About Universal Health Services One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $15.8 billion in 2024. UHS was again recognized as one of the World’s Most Admired Companies by Fortune; listed in Forbes ranking of America’s Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 99,000 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com

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

This position 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.