What are the responsibilities and job description for the Utilization Review Specialist position at Legends Recovery Center of Ohio LLC?
Looking for UR Specialist with experience in SUD
The Utilization Review Specialist is responsible for monitoring adherence to the facilities Utilization Review plan to ensure the effective and efficient use of SUD services and monitor the appropriateness of facility admissions and extended stays in each program for insurance purposes. SUD UR experience is a MUST.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
1. Maintain Smartsheets with client information, insurance, and authorization approvals.
2. Communicating between admissions, billing, and clinical departments to ensure client funding from insurance is obtained.
3. Properly document all authorizations for services.
4. Maintains efficient methods of ensuring the medical necessity and appropriateness of admissions.
5. Submit initial and concurrent reviews to insurance companies for authorization.
6. Maintains efficient methods of ensuring the medical necessity and appropriateness of admissions.
REQUIRED QUALIFICATIONS:
1. S/he must be detail oriented.
2. S/he must possess and demonstrate effective organizational skills.
3. S/he must possess excellent time management skills with a proven ability to meet deadlines.
4. S/he must be proficient with KIPU (EMR) and Smartsheet.
5. S/he should demonstrate good verbal and written communication skills.
Job Type: Full-time
Pay: $25.00 - $30.00 per hour
Expected hours: 40 per week
Benefits:
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
People with a criminal record are encouraged to apply
Ability to Commute:
- Green Springs, Ohio 44836 (Required)
Ability to Relocate:
- Green Springs, Ohio 44836: Relocate before starting work (Required)
Work Location: In person
Salary : $25 - $30
