What are the responsibilities and job description for the Utilization Review Specialist for Substance Abuse/Mental Health position at Element Medical Billing?
Join our team of supportive, fun, and goal-oriented people. If you are someone with previous hands-on experience in substance abuse and/or mental health, and looking to transition from case management, admissions, discharge coordinator, social service assistant, and Clinical support and eager to learn more about back-end operations, we want to hear from you!
Element Medical Billing is a premier 3rd party substance abuse billing company seeking a dedicated individual to join our Utilization Review team. We are looking for UR Specialists that have experience in all levels of care per ASAM criteria.
The Utilization Review Specialist (URS) is responsible for obtaining authorizations through the medical insurance company and relaying the information to the facility. The URS will utilize ASAM, LOCUS, Inter-Qual, and a knowledge of 12 step programs to assist in demonstrating medical necessity for the requested services.
**Previous experience working in substance abuse or mental health facilities a plus.
Job Functions / Requirements:
· Ability to navigate and use EMR systems such as KIPU
· Ability to use Microsoft Office 365 programs (Word, Excell, Outlook, Calander)
· Knowledge of Substance use Disorders and Mental Health Treatment
· Knowledge in SUD and MH Levels of care and placement criteria
· Ability to interpret ASAM, LOCUS, Inter-Qual, 12 step, and Treatment Planning for SUD and MH and to apply the information to patient authorizations.
· Familiarity with psychotropic medications and DX codes
· Ability to interpret payer specific medical necessity guidelines, and to convey those guidelines to Medical providers and clinicians.
· Participate in interdepartmental communications to ensure accurate billing for services.
· Ability to communicate information in a professional and efficient manner
· Strong Organizational Skills & Time Management Capabilities
· Knowledge of HIPAA and protecting patient data
· Regular and reliable attendance is required
***Compensation based on experience***
Salary: $45,000.00 - $60,000.00 per year
We believe everyone should be treated equally regardless of race, sex, gender identification, sexual orientation, national origin, native language, religion, age, disability, marital status, citizenship, genetic information, pregnancy, or any other characteristic protected by law.
Job Type: Full-time
Pay: $45,000.00 - $60,000.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Work Location: In person
Salary : $45,000 - $60,000
