What are the responsibilities and job description for the Utilization Review position at Clean Recovery Centers?
Job Details
Description
The URM is responsible for creating and managing the flow of revenue for each client at Clean Recovery centers through liaison with insurance companies. The URS establishes a file on all incoming clients with insurance and maintains authorization for reimbursement from pre-certification through continuing stay reviews, through discharge of referral. The URS uses communication, reading and writing skills to establish the most appropriate reimbursement for the level of care being provided. The ideal candidate has skills in gathering information from clinicians, navigating EMRs and creating cases for presentation. Maintains internal tracking documents and spreadsheets daily and/or as instructed.
Qualifications
High School Diploma or equivalent
Experience with ASAM, Milima and LOCUS criteria
Ability to interpret ASAM, LOCUS InterQual, 12 step and Treatment Planning for SUD and MH and to apply information to patient authorizations
Ability to work with a team and have effective communication, organizational and interpersonal skills
Ability to work under stressful conditions and be flexible in relation to department needs
Understanding of medical and behavioral health terminology
Knowledge of state and federal statutes regarding patient confidentiality
Salary : $45,000 - $55,000
