The Utilization Review Specialist monitors patient charts and records to evaluate care concurrent with the patients treatment. Conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Being a Utilization Review Specialist collects and complies data as required and according to applicable policies and regulations. Reviews treatment plans and status of approvals from insurers. In addition, Utilization Review Specialist consults with physicians as needed. May require a bachelor's degree. Typically reports to a supervisor. Typically requires Reg ...istered Nurse(RN). Being a Utilization Review Specialist contributes to moderately complex aspects of a project. Work is generally independent and collaborative in nature. Working as a Utilization Review Specialist typically requires 4 to 7 years of related experience.More Show Less
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Utilization Review Coordinator Opportunity. This opportunity is for a dynamic and talented Utilization Review Coordinator for a growing hospital and offers PRN/Per diem schedule. Postion Summary. The incumbent will be responsible for proactively monitoring utilization of continuum services and optimizing reimbursement. Key Responsibilities include. Conduct admission reviews working with Assessment and Referral Services to stay abreast of admissio...
Job Description. Please only apply if you live within 30 miles (roughly) radius of Malibu CA. Please only apply if you are currently seeking part-time employment. This position may turn into a full time position at a later date. The UR staff is responsible for working directly with providers and facility staff to ensure coordinated, continuous coverage for current clients in treatment. UR specialists are tasked with advocating on the client’s beh...
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Description. Job Title. Utilization Review Specialist. Location. Chicago. Job Type. Full-Time. Reports to. Director of Revenue Cycle Manager. . In Direct Reporting to. Chief Clinical Officer. Direct Reports. none, subject to change in future. About Us. God Restoring Order (GRO) Community is a mental healthcare provider that specializes in trauma recovery services for males of color ages 5 and up. GRO services are grounded in an understanding of t...
Job Title. Utilization Review Specialist. Location. Chicago. Job Type. Full-Time. Reports to. Director of Revenue Cycle Manager. . In Direct Reporting to. Chief Clinical Officer. Direct Reports. none, subject to change in future. About Us. God Restoring Order (GRO) Community is a mental healthcare provider that specializes in trauma recovery services for males of color ages 5 and up. GRO services are grounded in an understanding of the neurologic...
Company Description. Red Rock Billing is a premier behavioral health billing company based in South Jordan, Utah, specializing in comprehensive revenue cycle management services for behavioral health providers. Our expert team works with mental health professionals, addiction treatment centers, and other behavioral health organizations to streamline billing processes, optimize reimbursements, and ensure compliance with evolving healthcare regulat...
Job Title : Retro Claims Reviewer. Location : West Hills/Canoga Park 91305. Compensation. LVN $38-$40 hourly. RN $45-$50 hourly. Overview. The Retro Claims Reviewer is responsible for auditing and reviewing medical claims to ensure accuracy, regulatory compliance, and proper adjudication. This. role is ideal for a Licensed Vocational Nurse (LVN) or Registered Nurse (RN) with hands-on experience in Utilization Management (UM) and a strong understa...
Position Summary. Person in this position is responsible for collecting clinical information and communicating with MCOs in a timely manner in order to advocate for the highest level of care that is supported by the clients acuity, and in compliance with regulations as defined by WestCare and its regulatory and accrediting agencies. Person in the position is also responsible for communicating with insurance companies/payor sources as an advocate ...
Title. Utilization Review Specialist/Behavioral Health Substance Abuse. Reports to. UR Manager. FLSA Classification. Exempt. Full-Time or Part-Time. Full-Time. Salary Range. $60,000 to $62,000. Starting pay varies based on location and experience, in compliance with specific state wage regulations. Competitive rates tailored to your geography and expertise. Position Overview. . The Utilization Review Specialist is responsible for all aspects of t...
Job Details. Job Location. Bensalem , PA. Position Type. Full Time. Education Level. Bachelor’s Degree. Salary Range. Undisclosed. Job Shift. Day. Description. Job Summary. The Utilization Review Specialist is responsible for the evaluation of clinical record to determine the appropriateness and necessity of continued stay, type of treatment, and length of treatment. . Responsibilities and Duties. . Analyzes clinical record and works with the tre...
Job Info. El Dorado Springs Hospital. Job Title: Utilization Review Specialist. Job Type: Full Time. What we offer. Fundamental to providing great care is supporting and rewarding our team. In addition to your base compensation, this position also offers. Comprehensive medical, dental, and vision plans, plus flexible-spending and health- savings accounts. Competitive paid time off. Income-protection programs, such as life, accident, critical-inju...
Job Info. El Dorado Springs Hospital. Job Title: Utilization Review Specialist. Job Type: Full Time. What we offer. Fundamental to providing great care is supporting and rewarding our team. In addition to your base compensation, this position also offers. Comprehensive medical, dental, and vision plans, plus flexible-spending and health- savings accounts. Competitive paid time off. Income-protection programs, such as life, accident, critical-inju...
