What are the responsibilities and job description for the Insurance Benefits Coordinator- Part-Time position at Haven Behavioral Healthcare?
UR Coordinator ( Utilization Review)
Part-Time : typical business hours.
Approx. hours : 8 : 30am-12 : 30pm, Mon, Tues, Thurs, Fri & 12 : 30pm-4 : 30pm Wed.
Provide integral services for patients towards their group therapy program!
Haven offers group therapy for clients in need of PHP, IOP and TOP. We are in need of creative, energetic, curious minded, and detail oriented individuals to assist clients in moving towards and through their various levels of care with the ultimate goal of improved mental health and / or sobriety. We teach patients real world skills that improve personal and professional lives! We offer groups via an in person and virtual model in order to serve clients all across New Mexico. Are you a systems minded individual that has experience with many of the functions below? Give us a call and inquire about the position! Consider clicking on Apply and take the next step to being a part of a team that lifts up the lives of out patients!
POSITION SUMMARY :
Develops and implements systems for the authorization, concurrent and retrospective review of inpatient admissions and services.
Obtain authorization for each admitted patient.
Review and monitor each step of the authorization process to proactively identify potential problems.
Interact with physicians and therapists constantly to assure patient assessment and treatment plan is accurately and consistently reflected in facility documentation.
Track enrollment status continuously to act on changes and initiate retrospective review as necessary.
Monitor staff communication with external representatives to ensure it is professional and thorough.
Maintain cumulative documentation regarding actions initiated by staff and self.
Conduct reviews to ensure that services and documentation conform to the facility protocols, applicable laws and regulations and the requirements of funding sources.
Collaborate with physicians, nurses, and therapists regarding medical necessity for stay, appropriateness of treatment and estimated length of stay.
Attend meetings daily to obtain and present information on patient status, care and stay.
Communicate authorization status, issues or problems to appropriate staff.
Obtain and maintain authorization for each patient. Problem-solve issues relating to stay or service.
Respond quickly and effectively to requests for information.
Nurture positive and professional relationships with external sources.
EDUCATION :
Bachelors Degree in Behavioral Health field or equivalent experience.
EXPERIENCE :
Two years clinical experience in a psychiatric setting. Knowledge of medical terminology and insurance and billing practices is essential to this position.
Licensed clinician and any prior experience in UM preferred but not required.
Haven Behavioral Healthcare is proud to be an equal opportunity workplace dedicated to pursuing and hiring a diverse workforce.
