What are the responsibilities and job description for the Utilization Review Specialist position at Ultimate Analysis Billing?
Ultimate Analysis Billing– West Palm Beach, FL
We are a nationally recognized substance abuse treatment and billing company. Our mission is to provide quality and individualist substance abuse treatment at all levels of care. Our employees are the heart of our company and we look forward to the new addition.
We are looking for a motivated individual to join our team as our Utilization Review Specialist at our West Palm Beach, FL location.
Responsibilities for this position include:
- Responsible for concurrent and retrospective records review activities;
- Responsible for gathering clinical information and report to insurance carriers, regarding progress and continued stay;
- Responsible for communicating information to appropriate staff members to assist in discharge planning;
- Responsible for providing feedback and directives necessary to meet all contractual obligations, including licensing and credentialing standards.
- Evaluates patient clinical and medical records to determine severity of patient's disease and determine the appropriateness of level of care.
- Serves as liaison for patients and Royal Life Centers LLC., with insurance companies. Perform pre-authorization, concurrent and retrospective reviews as needed for inpatient/or outpatient services.
- Negotiates and advocates for patient length of stay and level of care.
EDUCATION:
Graduate from an accredited college or university with at least a Bachelor’s Degree in Psychology, Social Work, Nursing, or another health-related field preferred.
EXPERIENCE:
Minimum 2 years utilization review experience in Behavioral Health.
Experience in an acute psychiatric facility or partial hospitalization setting preferred.
- Knowledge of the Principles and Practices of the discipline.
- Knowledge of Joint Commission Standards.
- Demonstrates Proficiency in Communication & Written skills.
- Knowledge of State & Federal Statutes Regarding Patient Confidentiality laws.
Qualifications:
- Pass criminal background check
- Pass pre-employment drug screen
- Must be 18 yrs. old.
Benefits Include: Medical, Dental and Vision Insurance, two weeks of paid vacation and paid holidays after 90-day probationary period.
Job Type: Full-time
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Work Location: Hybrid remote in Palm Springs, FL 33406
