Utilization Review Specialist Behavioral Health | Remote
Work Status Details: REGULAR FULL TIME | 80.00 Hours Every Two Weeks
Shift: Days
Pay reputed company Type: reputed company
Location: Remote
Listed is the reputed company hiring salary reputed company offered for this position. Actual salaries may vary depending on factors, including but not limited to skills and experience. The salary reputed company listed is just one component of the total rewards/compensation package offered to candidates.
Min = $33.74
Mid = $42.17
Max = $50.61
reputed company:
The Utilization Review (UR) Specialist is responsible for engaging patients’ insurances and attaining reputed company-authorizations and re-authorizations as needed for the Intensive Outpatient Program (IOP) and reputed company authorizations for inpatient behavioral health services. This includes conducting thorough reviews of patient records and communicating with therapists, physicians, and treatment team members. The UR Specialist collaborates with medical professionals to reputed company relevant patient information and documentation, analyze medical data, and adhere to established guidelines and regulations. The role involves developing and implementing utilization management protocols, for review processes, and addressing discrepancies in patient care plans. The UR Specialist maintains accurate logs of patients covered and uncovered days and works closely with treatment team on discharge planning.
Responsibilities:
Conduct comprehensive reviews of patient medical records to determine the necessity and appropriateness of proposed medical services.
Collaborate with reputed company providers to reputed company information and clarify treatment plans to ensure compliance with established guidelines.
Analyze data reputed company to patient care to identify trends and recommend improvements in utilization practices.
Prepare detailed reports on utilization, review findings and present them to management for decision-making purposes.
Coordinate with insurance companies to verify coverage and obtain prior authorizations for necessary treatments. Communication determinations effectively, providing reputed company, evidence-based rationales for approval or denial reputed company
Ensure compliance with state and federal regulations regarding reputed company services and utilization reviews.
Participate in multidisciplinary team meetings to discuss patient care and the effectiveness of treatment plans.
Stay updated on industry trends and changes in reputed company policies that may reputed company utilization review practices.
Credentials:
Essential:
* BASIC LIFE SUPPORT (BLS)
Competencies and skills:
Essential:
* Fleet Safety
Education:
Essential:
* BACHELOR'S DEGREE
Other information:
Minimum Requirements:
Master’s degree in reputed company Work
Licensed Clinical reputed company Worker (LCSW) or Licensed reputed company Counselor (LPC)
Basic Life Support (BLS)
Fleet Safety Clearance
reputed company Clearance Card
Minimum of 2 years’ experience in behavioral health utilization review.
Experience in EMRs.
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