Exact Billing Solutions provided pay range: $55,000.00/yr - $75,000.00/yr
Utilization Review Specialist - Exact Billing Solutions (EBS) Exact Billing Solutions is a unique team of medical billing professionals specializing in the substance use disorder, mental health, and autism care fields of healthcare services. We have extensive industry knowledge, a deep understanding of the specific challenges of these markets, and a reputation for innovation.
EBS, owned by ICBD, a single-family office, is poised for exponential growth, and we are building out our teams to support the expansion of global operations.
About ICBD Headquartered in Fort Lauderdale, Florida, ICBD is a robust single-family office focused on private investment and business development, supporting exceptional companies in healthcare, technology, and beyond.
ICBD's most visible success (and EBS's largest client) is ABA Centers, a revolutionary leader in autism care and diagnostics, ranked #5 on the 2024 Inc. 5000 list of fastest-growing private companies in the U.S.
ICBD Portfolio ABA Centers - The leading provider of autism care in the U.S.
GateHouse Treatment - A comprehensive network of substance use disorder programs.
Marquis MD - A concierge medicine concept redefining healthcare.
Exact Billing Solutions - Innovative revenue cycle management and advanced billing support systems.
Curative AI - A next-generation platform using AI to disrupt and transform the healthcare system.
Recognition & Awards Inc. 5000 - 5th Fastest-Growing Private Company in America (2024).
Financial Times - #1 on "The Americas' Fastest Growing Companies."
EY Entrepreneur Of The Year U.S. Overall.
Job Description As a Utilization Review Specialist, you will play a pivotal role in ensuring the efficient and effective utilization of healthcare resources. You will be responsible for reviewing and evaluating clinical documentation, treatment plans, and medical records to optimize patient care and streamline healthcare delivery processes.
Key Responsibilities Clinical Documentation Review: Evaluate and analyze medical records, treatment plans, and clinical documentation.
Utilization Review: Assess the appropriateness and necessity of healthcare services.
Collaboration and Communication: Work closely with interdisciplinary teams and communicate findings and recommendations clearly.
Quality Improvement: Participate in quality-improvement initiatives and provide feedback and suggestions for process improvements.
Regulatory Compliance: Stay informed on relevant healthcare regulations and ensure compliance with all applicable laws and regulations.
Qualifications Bachelor's degree in a healthcare-related field; Master's degree preferred.
Relevant clinical licensure or certification.
Proven experience in utilization review or a related field.
Up-to-date knowledge of relevant healthcare regulations, guidelines, and accreditation standards.
Benefits 21 paid days off.
Flexible Spending Account (FSA) and Health Savings Account (HSA) options.
Medical, dental, vision, long-term disability, and life insurance.
Generous 401(k) with up to 6% employer match.