ABA Utilization Review (UR) Specialist

Spectrum Billing Solutions

Skokie, IL · HybridJobPosted 4mo agoSeen in employer's feed 5 days ago

Skokie, ILHybridJobNo compensation foundPosted 4mo agoSeen in employer's feed 5 days ago

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At a glance

Compensation

No compensation found

Location

Skokie, ILHybrid

Work Authorization

Not specified

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Job overview

Spectrum Billing Solutions is hiring an ABA Utilization Review (UR) Specialist. Spectrum Billing Solutions is seeking an ABA Utilization Review (UR) Specialist to join their growing team. The specialist will review clinical information and obtain initial and continuing authorizations for ABA and related services. The ideal candidate is passionate, motivated, detail-oriented, and interested in working in a cohesive and rewarding environment.

Key focus areas include Review patient admission and clinical information to ensure medical necessity and compliance of utilization review guidelines., Obtain initial and continuing authorization for treatment services., and Manage authorization denials including referral for peer review..

Successful candidates bring 3+ Years ABA Experience. Important skills include Medical Necessity Review, Compliance Of Utilization Review Guidelines, Authorization Management, Documentation, Tracking Authorization Cases, and Collaboration With Clinical Staff.

Skills & qualifications

RequiredNice to have

Skills

Medical Necessity ReviewCompliance of Utilization Review GuidelinesAuthorization ManagementDocumentationTracking Authorization CasesCollaboration With Clinical StaffCommunication With Clinical StaffUnderstanding Payer RequirementsConfidentiality of Patient InformationHIPAA RegulationsCommunicationOral CommunicationAttention to DetailWork IndependentlyCollaborationMulti-TaskTime ManagementMeeting DeadlinesInsurance Benefits and CoveragesComputer SkillsMicrosoft WordExcelBilling SoftwareMental and Behavioral Health Treatment Services

Qualifications

3-5 Years ABA and/or Behavioral Health ExperienceBachelor's or Master's Degree

Benefits

Medical Insurance

Dental Insurance

Vision Insurance

Paid Time Off

401(k) Match

Full job description

Spectrum Billing Solutions offers industry-leading revenue cycle management services for healthcare providers. Our team has deep industry knowledge, technology, and experience to ensure our client’s revenue cycle is managed in the most efficient and streamlined manner.

We are seeking to add an ABA Utilization Review (UR) Specialist to our growing team. The ABA UR Specialist will utilize his or her knowledge and skills to review clinical information and obtain initial and continuing authorizations for ABA and related services. The ideal candidate is passionate, motivated, detail-oriented and interested in working in a cohesive and rewarding environment.

This is a fully remote or office/home hybrid position.

Your Responsibilities:

Review patient admission and clinical information to ensure medical necessity and compliance of utilization review guidelines.
Obtain initial and continuing authorization for treatment services.
Manage authorization denials including referral for peer review.
Document and record all necessary information.
Monitor and track new and ongoing authorization cases.
Collaborate and communicate with clinical staff to ensure necessary information is obtained and timely reviews are performed.
Assist external clients in understanding payer requirements for authorizations.
Participate in team meetings.
Maintain confidentiality of patient information and adhere to HIPAA regulations.

What we offer you:

Flexible work environment
Competitive Salary
A close-knit team of talented and skilled individuals.
Growth opportunities
Benefits – Medical, Dental, Vision
Flexible Paid Time Off
401K with Company match
Supplemental Benefits

Qualifications:

3-5 years of related ABA and/or Behavioral Health experience.
Bachelor’s or master’s degree preferred.
Superior written and oral communication skills
Attention to detail to ensure necessary information is captured and properly documented.
Ability to work independently and within a team.
Ability to multi-task, prioritize and meet expected deadlines.
Solid understanding of insurance benefits and coverages.
Strong computer skills (Word, Excel, billing software).
Understanding of mental and behavioral health treatment services.

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