What are the responsibilities and job description for the Utilization Review Coordinator position at Axiom Care?
Job Type
Full-time
Description
Axiom Care is a fast-paced, rapidly growing substance abuse treatment and sober living housing provider with locations in the Phoenix metro area and Apache Junction. We primarily serve low-income and justice-involved individuals who are seeking to change their life for the better. We achieve this by offering multiple levels of care along with medical services, evidence-based professional counseling, case management, housing assistance, employment assistance, and more.
Job Summary
The UR Coordinator's primary responsibility is managing, reviewing, and monitoring utilization of patient resources and obtaining payor authorization as required for all provided services. The UR Coordinator will function as a liaison between payor source(s), the finance office, and the clinical treatment team, providing information and feedback to assist in optimum patient care and reimbursement.
Duties / Responsibilities
- Review of patient admission data and clinical documentation to ensure compliance with insurance and governmental regulations relating to medical necessity and case documentation.
- Collect and compile data needed for prior authorization, concurrent review, discharge notifications and retrospective reviews.
- Ensure all authorization requests have been completed for inpatient and outpatient services, according to applicable facility and insurance policies.
- Maintains detailed and complete documentation regarding the UR process for each case.
- Actively communicate with interdisciplinary team regarding patient diagnosis, utilization of services, length of treatment, authorization status and case documentation.
- Participation with departmental staff in quality improvement meetings and projects.
- Preparing memorandum, letters, correspondence, and comprehensive UR status summaries.
- Other duties as assigned.
Requirements
Required Skills / Abilities
Education and Experience
