Work as a member of a multi-disciplinary treatment team reviewing patient care and treatment options for both inpatient and outpatient services. Proactively monitor and optimize reimbursement for external reviewers/third-party payers.
Pay Range: $32/hr. to $60/hr.
Work Schedule: Monday to Friday from 8:00 a.m. to 4:30 p.m.
Responsibilities: Conduct admission reviews
Conduct concurrent and extended stay reviews
Prepare and submit appeals to third-party payers
Maintain appropriate records of the Utilization Review Department
Provide staff in-service training and education
Maintain confidentiality of patients at all times
Cope well with stress and possess a strong sense of compassion
Interact sensitively with persons of various social, cultural, economic, and educational backgrounds
Proficiency with Microsoft Office applications (Outlook, Word, Excel, PowerPoint)
Strong organizational skills with the ability to prioritize projects, work independently, manage multiple tasks, and meet deadlines
Strong written and verbal communication skills
Strong interpersonal skills with the ability to work with people from diverse backgrounds
Work independently and as part of a team
Good judgment, problem-solving, and decision-making skills
Demonstrated commitment to collaborative work and leadership skills
Ability to work in a fast-paced, expanding organization
Skills: Demonstrated knowledge of health care service delivery systems and third-party reimbursement
Two or more years of experience working in a managed care environment
Ability to apply and interpret admission and continued stay criteria
Strong understanding of admission and discharge functions
Familiarity with medical terminology, diagnostic terms, and treatment modalities
Knowledge of medical record-keeping requirements
Ability to comprehend psychiatric evaluations, consults, and lab results
Preferred Qualifications: Current license as RN, LVN/LPT, LCSW
Master’s degree in Social Work, Behavioral Science, or related field
Current BLS Certification for Healthcare Providers
Benefits: 401K Retirement Plan
Health Insurance
Vision Insurance
Dental Insurance
Pet Insurance
Healthcare Spending Account & Dependent Care Spending Account
Life Insurance (Supplemental Life, Term, and Universal plans are also available)
PTO Plan with Holiday Premium Pay
PTO Cash Out option
Sick Pay
Short and Long-Term Disability (with additional buy-in opportunities)
Tuition Reimbursement
Employee Assistance Program
ID Theft Protection