5 Utilization Review Specialist (remote) Jobs in El Paso, TX
Remoteworker Us is Hiring a Remote Utilization Review Specialist (remote)
Utilization Review Specialist/Behavioral Health Substance Abuse
FLSA Status: Exempt
Classification: Full-Time
Reports To: The UR Specialist will report to UR Manager.
Job Overview: The Utilization Review Specialist is responsible for all aspects of the authorization of treatment via insurance and managed care companies. The Utilization Review Specialist provides appropriate client information to third party payers regarding the medical necessity of treatment in a timely manner. The Utilization Review Specialist will also perform pre-certification reviews, concurrent reviews and will perform appeal reviews as needed.
Responsibilities and Duties:
- Act as agency liaison with insurance and managed care companies for authorization of treatment costs, representing company in a positive manner in the professional Participate in staff meetings as needed
- Clear communication with supervisors, co-workers, and facilities
- Keeps abreast of changes to, and monitors compliance with, State and Federal laws and regulations in areas of insurance/ third party payers
- Protects the confidentiality of patients and the privacy of staff
- Uses a computer to type correspondence, reports and other items as requested, ensuring that typing is accurate
- Process data in conjunction with compliance consultant in order to present it effectively using established statistical methods
- Demonstrates the willingness to accept responsibility
- Performs other duties as assigned by the Director of Utilization Review
- Prior Utilization Review experience in a Substance abuse environment is mandatory.
- Knowledge of ASAM guidelines.
- Ability to establish rapport with and supervise employees as well as professional staff and peers
- Ability to work under stressful conditions and is flexible in relation to department needs.
- Knowledge of medical terminology.
- Demonstrates proficiency in Verbal & Written Communication
- Skills.
- Knowledge of State & Federal Statutes Regarding Patient Confidentiality Laws.
- Knowledge of Drug-Free Workplace Policies. Knowledge of Corporate Integrity & Compliance Program.
- Knowledge of state guidelines and accreditation agency standards
- KIPU experience required, Best Notes experience a plus
Some positions may require a certain level of education, related work experience, knowledge, skills, abilities, licensures, certification and/or other job related requirements.
- Prior Utilization Review experience in a Substance abuse environment is mandatory.
- BA in Psy. min. Three to Five (5) years experience in Case Management/Utilization Review (as either CADC, LAADC, LCSW, LMHC, LMFT, Case Manager, or Utilization Review Coordinator).
Job Summary
Full Time
$65k-83k (estimate)
06/20/2024
07/17/2024
The job skills required for Utilization Review Specialist (remote) include Managed Care, Case Management, Confidentiality, Integrity, Written Communication, etc. Having related job skills and expertise will give you an advantage when applying to be an Utilization Review Specialist (remote). That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Utilization Review Specialist (remote). Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Utilization Review Specialist (remote) positions, which can be used as a reference in future career path planning. As an Utilization Review Specialist (remote), it can be promoted into senior positions as an Utilization Review Manager - Home Care that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Utilization Review Specialist (remote). You can explore the career advancement for an Utilization Review Specialist (remote) below and select your interested title to get hiring information.
If you are interested in becoming an Utilization Review Specialist, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become an Utilization Review Specialist for your reference.
Step 1: Understand the job description and responsibilities of an Accountant.
Quotes from people on Utilization Review Specialist job description and responsibilities
Utilization Review Specialists ensure that Doctors and Nurses choose only the best treatments for them.
03/11/2022: Fort Myers, FL
Utilization review typically refers to the review of services that have already been delivered, while utilization management often refers to the review of coverage for future medical services.
02/16/2022: Louisville, KY
Assess plans for patient care and determine what treatment is appropriate and most cost-effective
02/15/2022: Augusta, GA
Analyze electronic medical records, and inform medical staff whether a medical claim is denied,
03/11/2022: Boston, MA
Prepares and submits regular reports on utilization control and on review activities.
02/26/2022: Reading, PA
Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.
Career tips from people on Utilization Review Specialist jobs
Know where to find utilization review jobs.
03/13/2022: Clarksville, TN
Create a utilization review cover letter.
02/18/2022: Reno, NV
Sign up for free credit monitoring.
03/16/2022: New London, CT
Set up documentation shortcuts.
03/05/2022: Lawton, OK
Take the certification examination.
05/08/2022: New Bedford, MA
Step 3: View the best colleges and universities for Utilization Review Specialist.
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