Utilization Review Coordinator - PRN position
Part-timeGeorgetown Behavioral Health Institute
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At a glance
Requirements
Credentials this posting asks for.
Job overview
Georgetown Behavioral Health Institute is hiring an Utilization Review Coordinator - PRN position. The Utilization Review Coordinator works with insurance companies and managed care systems to secure initial authorization, concurrent, and retrospective review for inpatient, partial, and intensive outpatient admissions and services. This role involves obtaining authorization for each admitted patient and proactively identifying potential problems in the authorization process to ensure patients access their full benefits.
Key focus areas include Obtain authorization for each admitted patient, Review and monitor each step of the authorization process, and Proactively identify potential problems to help patients access benefits.
Successful candidates bring CPR Certification, Verbal De-escalation Certification, and Physical Crisis Management Certification. Important skills include Verbal De-escalation and Physical Crisis Management. Preferred (not required): Utilization Review, Case Management, Medical Terminology, and Acute Psychiatric Inpatient Care Criteria.
Skills & qualifications
Skills
Qualifications
Benefits
Full job description
Our inpatient behavioral health hospital is seeking a PRN Utilization Review Coordinator.
This position is responsible for working with insurance companies and managed care systems for the initial authorization, concurrent and retrospective review of inpatient, partial, and intensive outpatient admissions and services. Previous experience in utilization review or case management desirable.
This position will obtain authorization for each admitted patient. Review and monitor each step of the authorization process to proactively identify potential problems to help patients access the full range of their benefits through the utilization review process.
Requirements
Education and/or Licensure – Bachelor’s degree or equivalent in nursing preferred.
Experience – 3-5 years Admitting or Financial Counseling preferred. Prefer two years clinical experience in a facility with medical terminology and in criteria for acute psychiatric inpatient care. Knowledgeable of insurance coverage and billing practices preferred. Previous experience in utilization review or case management desirable.
Additional Requirements – Must possess or obtain a valid CPR certification and certified in facility approved verbal de-escalation and physical crisis management techniques within 30 days of hire and prior to completion of orientation required.
Benefits
Full-time employees are eligible for medical, dental, vision, company paid disability, 401(k) and a generous amount of paid time off.
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