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.
Skills Required
- Bachelor's degree or equivalent in nursing
- Three to five years of admitting or financial counseling experience
- Two years of clinical experience in a facility
- Experience with medical terminology and criteria for acute psychiatric inpatient care
- Knowledge of insurance coverage and billing practices
- Previous utilization review or case management experience
- Valid CPR certification within 30 days of hire and before completing orientation
- Facility-approved verbal de-escalation and physical crisis management certification within 30 days of hire and before completing orientation
What We Do
Georgetown Behavioral Health Institute is a state-of-the-art, 118-bed acute care psychiatric hospital offering comprehensive mental healthcare programs and services for adults, teens, and seniors. It provides multidisciplinary diagnostic and treatment mental health services.
