Utilization Review Coordinator - PRN position

Georgetown Behavioral Health Institute•Georgetown, TX

1d•Onsite

About The Position

Our inpatient behavioral health hospital is seeking a PRN Utilization Review Coordinator. This position is responsible for working with insurance companies and managed care systems for the initial authorization, concurrent and retrospective review of inpatient, partial, and intensive outpatient admissions and services. This position will obtain authorization for each admitted patient. Review and monitor each step of the authorization process to proactively identify potential problems to help patients access the full range of their benefits through the utilization review process.

Requirements

Must possess or obtain a valid CPR certification.
Must be certified in facility approved verbal de-escalation and physical crisis management techniques within 30 days of hire and prior to completion of orientation.

Nice To Haves

Bachelor’s degree or equivalent in nursing preferred.
3-5 years Admitting or Financial Counseling preferred.
Two years clinical experience in a facility with medical terminology and in criteria for acute psychiatric inpatient care.
Knowledgeable of insurance coverage and billing practices preferred.
Previous experience in utilization review or case management desirable.

Responsibilities

Obtain authorization for each admitted patient.
Review and monitor each step of the authorization process to proactively identify potential problems to help patients access the full range of their benefits through the utilization review process.
Work with insurance companies and managed care systems for the initial authorization, concurrent and retrospective review of inpatient, partial, and intensive outpatient admissions and services.