What are the responsibilities and job description for the Utilization Review Specialist position at Indigo Billing?
Position: Utilization Review Specialist (Third Party)
Company Name: Indigo Billing
Job Type: Full Time Onsite Schedule
Schedule: Monday through Friday
Experience Type: Substance Abuse and/or Mental Health field
About Us:
Indigo Billing is a third party utilization review, billing, and consulting company located in Costa Mesa, CA who services substance abuse and mental health facilities. We are seeking a utilization review specialist to join our rapidly growing team.
Job Duties and Key Responsibilities:
● Successfully complete initial admission reviews, continued stay reviews and peer reviews.
● Effectively communicate the outcome of authorization requests, as well as status, to clients and the billing department.
● Review patient medical records and complete audits when necessary to support clients in strengthening their medical records.
● Continuously check and respond to calls, voicemails, faxes, and emails throughout the work day.
● Contact insurance companies in a timely manner to ensure caseload is completed daily.
● Obtain the maximum amount of time authorized in substance abuse and mental health treatment for all levels of care.
● Compliant with HIPAA guidelines as well as Indigo Billing’s policies and procedures.
Education and Licensing:
● Licensing or credentials in the behavioral health or medical field is a plus, but not a requirement.
Knowledge and Experience:
● Experience is preferred but not required. We are willing to train the right candidate.
● Proficient in the use of EMRs.
● Knowledge of ICD-10 diagnosis codes for substance use disorders and mental health disorders.
● Knowledge of ASAM criteria, MCG guidelines, as well as all other insurance company guidelines.
● Knowledge of medical necessity guidelines for detox, residential, PHP and IOP levels of care for substance abuse and mental health.
Skills and Abilities:
● Strong organizational skills and time management skills with ability to prioritize caseload, insurance company time zones, manage multiple tasks and meet deadlines.
● Ability to work independently with little to no supervision as well as with a team in an expanding, fast paced organization.
● Strong interpersonal skills including excellent communication verbally as well as in writing with colleagues, insurance companies and clients.
● Possess a solution-oriented mindset surrounding problem solving.
Compensation:
To be determined as it depends upon the candidate’s experience.
Job Type: Full-time
Benefits:
401(k)
401(k) matching
Dental insurance
Health insurance
Paid time off
Vision insurance
Schedule:
8 hour shift
Day shift
Monday to Friday
Experience:
Utilization review: 1 year (Preferred)
Willing to train the right candidate
Salary : $23 - $30