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. 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.
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.
Benefits
- Career development opportunities across UHS and our 300+ locations!
- Diverse programming to expand your experience
- Competitive Compensation & Generous Paid Time Off
- Excellent Medical, Dental, Vision and Prescription Drug Plans
- Employee Assistance Program
- 401(K) with company match and discounted stock plan
- Pet Insurance
- SoFi Student Loan Refinancing Program
- Tuition Assistance
- Employee Referral Program
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What This Job Offers
Job Type
Full-time
Industry
Hospitals
Number of Employees
5,001-10,000 employees
