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Part Time Utilization Review Specialist

Options Behavioral Health Lawrence, IN Part-Time
$83,960.00 (Careerbuilder est.) What is the Careerbuilder Estimated Salary? Only about 20% of the jobs in our search results contain salary information. When a job posting doesn’t include a salary, we estimate it by looking at similar jobs in the same industry in that location. It is not necessarily endorsed by the employer and actual compensation may vary based on your experience.
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ESSENTIAL FUNCTIONS:

Act as liaison between managed care organizations and the facility’s professional clinical staff.

Conduct reviews in accordance with certification requirements of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements.

Inform clinical and medical staff of any specific concerns that would extend or restrict the length of stay of patients.

Keep accurate record of all contact with external organizations and persons who have legitimate interest and legal access to information on the care of patients.

Facilitate peer review calls between facility and external organizations.

Act in coordination with the leadership team of the facility or corporate office to improve the quality of services provided within the organization.

Assist the admissions department with pre-certifications of care.

Initiate and complete the formal appeal process for denied admissions or continued stay.

Provide ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates.

Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office.

OTHER FUNCTIONS:

Perform other functions and tasks as assigned.

 

Recommended skills

Managed Care
Appeals
Coordinating
Inform

Location

CareerBuilder Estimated Salary What is the Careerbuilder Estimated Salary? Only about 20% of the jobs in our search results contain salary information. When a job posting doesn’t include a salary, we estimate it by looking at similar jobs in the same industry in that location. It is not necessarily endorsed by the employer and actual compensation may vary based on your experience.

x

What is the Careerbuilder Estimated Salary?

Only about 20% of the jobs in our search results contain salary information. When a job posting doesn’t include a salary, we estimate it by looking at similar jobs in the same industry in that location. It is not necessarily endorsed by the employer and actual compensation may vary based on your experience.
This estimation is based on Job title, Industry, Location and Skills
$83,960
Avg. Yearly Salary
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Job ID: 241c587c324f493d894a384f472c498c

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