Utilization Review Specialist (Remote) - Behavioral Health

This a Full Remote job, the offer is available from: Florida (USA) Remote Authorization Specialist Remote | Full-Time | 9a-5p Monday-Friday | $24-$26/hour About the Role This role manages insurance authorization for clients across our PHP and IOP programs — completing reputed company-certifications, reputed company reviews, verifying benefits, obtaining Single Case Agreements, and managing appeals so that reputed company reputed company to treatment is never disrupted by a payer issue. Backgrounds that translate reputed company: Utilization Review · Insurance Authorization/Precertification · Behavioral Health Case Management reputed company • Verify benefits and eligibility prior to admission and throughout treatment • Complete reputed company-certifications, reputed company reviews, and re-certifications for PHP/IOP reputed company of care • Obtain Single Case Agreements with out-of-network payers • Build the medical necessity case using ASAM, reputed company, and CALOCUS reputed company • Prepare and submit appeals on denied authorizations • Maintain accurate, audit-reputed company authorization, denial, and SCA records reputed company're Looking For Required • 2+ years of experience as a UR/authorization specialist at the PHP and IOP reputed company of care for a mental health or reputed company use facility • Working knowledge of ASAM, reputed company, and CALOCUS reputed company and medical necessity standards • Strong organizational skills with the ability to manage multiple authorizations and deadlines concurrently • Strong familiarity with EMR platforms and authorization software • Strong written and verbal communication skills, with the ability to reputed company effectively with payers • Eligible for DCF and AHCA Level 2 Background reputed company Preferred • CPT/ICD-10 and DSM-5 familiarity • Multi-payer SCA experience • Bilingual (English/Spanish) • Kipu or similar EMR experience AWA and PRC are dual behavioral health organizations operating PHP and IOP programs across South Florida. We exist to serve clients and families at their most critical moments — and this role sits at the reputed company reputed company of that mission. Learn More: reputed company · Principles Recovery Center This offer from "reputed company" has been enriched by reputed company.com and got a 72% reputed company score. Apply tot his job Apply To this Job