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Utilization Review Specialist

RiverValley Behavioral Health

Owensboro, KYFull-timeSeen todaySeen in employer's feed today

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At a glance

Compensation
No compensation found
Location
Owensboro, KY
Schedule
Full-time
Work Authorization
Not specified

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Job overview

The Utilization Review Support Specialist ensures insurance coverage for clients by obtaining pre‑certifications and authorizations, demonstrating medical necessity through documentation, and collaborating with programs and departments to coordinate the utilization review process.

Skills & qualifications

RequiredNice to have

Skills

General Office PracticesPublic InteractionOrganizational SkillsBasic Computer SkillsInsurance VerificationData ReportingCollaborationBackup Support

Qualifications

High School/GEDTwo Years Experience Working in Mental Health Utilization ReviewBachelor's Degree in Human Services-Related Field (Psychology, Social Work, Sociology)KY LPN/RN License

Benefits

Medical Insurance
Dental Insurance
Vision Insurance
Paid Time Off
401(k) Match
Tuition Assistance

Full job description

Compensation

$

Hours Per Week

40

Number Of Positions

1

Job Description

Position Title:Utilization Review Specialist

Location: Owensboro, KY 42301

Description:Description

The Utilization Review Support Specialist is responsible for assuring insurance coverage of clients for treatment, by obtaining pre-certification and authorizations for various levels of care from insurance companies (the payers). The pre-certification and authorizations of coverage are obtained by demonstrating medical necessity through the presentation of medical and clinical documentation meeting applicable criteria guidelines. Collaborate with programs and departments in coordinating the UR process.

Why Join Our Team?

  • Competitive pay

  • Comprehensive health, dental, vision, and Telehealth benefits

  • Paid time off plus 9 paid holidays

  • Retirement plan options

  • Tuition reimbursement and free CEUs

  • Clinical supervision and professional development

  • Wellness and Employee Assistance Programs

  • Mileage reimbursement for work-related travel

  • Public Service Loan Forgiveness (PSLF) eligible employer

Essential Functions:

  • Verifies insurance benefits and relays that information to appropriate parties.

  • Participates in skill enhancement activities.

  • Participants in treatment team meetings when necessary.

  • Provides data and reports to UR supervisor as requested.

  • Provides backup for the UR Specialist or other UR staff as needed.

  • Fosters collaborative working relationships among members of the UR team, programs providing UR services for, and management teams.

  • Other duties as assigned by UR Supervisor

Qualifications:Qualifications

Education and Experience:

  • High School/GED AND Two (2) years’ experience working in mental health utilization review (or equivalent)

OR

  • Bachelor’s Degree in human services-related field (Psychology, Social Work, Sociology)

OR

  • KY LPN/RN License

Knowledge and Skills:

  • Good knowledge of general office practices.

  • Ability to deal effectively with the public.

  • Good organizational skills.

  • Basic computer skills preferred.

Position Type: Full Time

Travel Percentage: None

Education Level:High School/GED

Job Shift: Day

Equal employment opportunity, including veterans and individuals with disabilities

PI287310983

Place of Work

On-site

Requisition ID

135239

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