Utilization Review Coordinator jobs in the United States

JOB SUMMARY

• Confirms resident’s eligibility and benefits.
• Builds cases and provides clinical information to insurance companies
• Submits required documentation on residents to initiate payment upon admission and terminate payment on discharge
• Performs other duties as assigned by Director of Admissions and UR

• Challenging and rewarding work environment
• Growth and development opportunities within UHS and its subsidiaries
• Competitive Compensation
• Excellent Medical, Dental, Vision and Prescription Drug Plan
• 401k plan with company match
• Generous Paid Time Off
• Free meals

EDUCATION

• Minimum of a Bachelor’s Degree in the area of Counseling, Psychology, or Social Services related field or Nursing BSN or RN. Masters level preferred.

EXPERIENCE

• Minimum of two years’ experience working in mental health, preferably in a residential or acute care setting. Knowledge of managed care organizations.
• Demonstrates understanding of third party reimbursement and processes involved; works well in prioritizing review processes within a managed care environment uses ability to interpret admission and continued stay criteria to advocate for appropriate maintenance of benefits.
• Demonstrates clear and consistent understanding of admission and discharge functions and can discuss current psychopathology with reviewers utilizing integrated clinical knowledge relating to diagnosis to evidenced clinical documentation.
• Demonstrates the ability to provide meticulous record keeping and organizational skills.