Utilization Review Coordinator

Human Resources • Morrilton, AR

2d • Onsite

About The Position

The Utilization Review Coordinator performs all functions related to utilization review. This role acts as a clinical liaison between payers and facilities, providing information and feedback to assist in optimal patient care reimbursement. The coordinator partners with Revenue Cycle Management to ensure all processes are managed effectively. Our company operates Residential Treatment Programs for individuals with Substance Abuse Disorder. We seek not merely to restore sobriety, but to transform our patients’ worlds from a state of darkness to vibrant technicolor. We believe that treatment is local, individualized, holistic, and relational.

Requirements

• Bachelor’s degree in behavioral health or related field required
• 1-2 years of professional clinical experience
• Familiarity with SharePoint and Excel
• Proficiency in Microsoft Office

Nice To Haves

• Clinical license preferred

Responsibilities

• Ensure all provided care is authorized within contractual timelines
• Initiate precertification for patients entering treatment programs using clinical knowledge
• Conduct concurrent reviews on patients to ensure documentation meets insurance requirements for level of care
• Track patients across locations to ensure timely and accurate billing
• Implement quality control by communicating effectively with treatment teams
• Obtain authorization for patients in Medicaid facilities
• Lead retroactive appeals to obtain authorization for discharged patients
• Collaborate with Revenue Cycle Management to resolve related issues

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level