Utilization Review Specialist
Recovery Unplugged Austin is looking for an experienced utilization review specialist. The job responsibilities are as follows:
- Facilitates clinical pertinence reviews on all patient admissions and continued stays.
- Analyzes patient records to determine legitimacy of admission, treatment, and length of stay and interfaces with managed care organizations, external reviewers and other payers.
- Contacts external case managers/managed care organizations for certification of insurance benefits throughout the patient's stay.
- Assists the treatment team in understanding the insurance company's requirements for continued stay and discharge planning.
- Proven experience in conceptualizing a case, and creating a clinical impression to present to all Managed Care Representatives.
- Knowledge of managed care and reimbursement principles.
- Excellent interpersonal skills.
- Collaboration and negotiation skills.
- Effective time management.
- Ability to effectively multi-task.
- Capable of priority setting.
- Effective oral and written communication skills.
- Use computers to read and organized charts.
- Participate in staff meetings as needed.
- Maintains and adheres to all policy and procedures respecting confidentiality of client's rights, anonymity, communication either written or verbal regarding client's identity and situation.
- Maintains documentation and files in an organized manner.
- Administrative duties.
- Communicate clearly with supervisors and coworkers.
- Follow all policies of Agency as applicable.
- Maintain appropriate boundaries and ethical behavior at all times with clients, families, co-workers and other professionals.
- Work as a positive team member.
License preferred but will consider non-licenses team member with comparable experience. Salary commensurate with experience. Recovery Unplugged Austin is an equal opportunity employer.
Recovery Unplugged is a music treatment center in Fort Lauderdale, Florida. We use music as well as the 12 steps as a catalyst for recovery and a way to help build rapport with our clients and allow them to open up more easily. Our (new) methods have been proven time and time again to be ground breaking and extremely successful. By joining this team you are joining a movement that thrives on giving our clients the best care possible and making our employees feel like they part of something great.
Wed, 7 Jun 2017 08:32:24 PDT