Utilization Review Coordinator - PRN position

About the role

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.

Responsibilities

• Obtain authorization for each admitted patient.
• Review and monitor each step of the authorization process to proactively identify potential problems.
• 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 in 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.
• Must be certified in facility-approved verbal de-escalation and physical crisis management techniques within 30 days of hire and prior to completion of orientation.

Benefits

• Medical, dental, and vision coverage.
• Company-paid disability insurance.
• 401(k) plan.
• Generous amount of paid time off.