Job Description

We are proud to offer top-notch, cost-effective solutions that span the entire range of tasks and processes within the healthcare sector. Our team is distinguished by their extensive industry knowledge and unwavering commitment to compliance.

Our success is built on a four-pillar foundation: exceptional management, meticulous process oversight, seasoned professionals, and state-of-the-art technology. This approach allows us to provide superior, cost-effective services to our international clientele.

The Utilization Review Admissions Specialist will be responsible for securing initial insurance authorizations for patient care and treatment. This role involves daily case assignments and weekend work on faxable items for insurance companies that do not offer live authorizations during those times.

Position Details: Full-time, Remote, $20.00/Hourly.

Responsibilities:

- Conduct utilization review tasks, including securing pre-authorizations and updating patient clinical information.
- Maintain precise and timely documentation.
- Build and maintain collaborative relationships with insurance care managers to ensure swift service delivery.
- Foster partnerships with healthcare providers and support staff through regular communication and interaction.
- Contribute to the Utilization Review Team to fulfill daily responsibilities.
- Address insurance denials through the appeals process when necessary.
- Submit retrospective reviews as required.
- Engage in ongoing professional development.

Please note that this list of duties and responsibilities is not exhaustive and may evolve based on company and client needs. Additional tasks may be assigned as business demands dictate.

Qualifications:

- Proficiency in medical and behavioral health terminology, physiology, and treatment methodologies.
- Experience in evaluating medical and behavioral health records for medical necessity.
- Proficient in using a personal computer and various software applications.
- Organized with a proven ability to meet deadlines.
- Exceptional customer service skills.
- Preferred experience in Substance Abuse/Mental Health fields.
Employment Type: Full-Time
Salary: $ 20.00 Per Hour

Job Tags

Hourly pay, Full time, Weekend work,

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