PRN Utilization Review Specialist Behavioral Health
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Job Location:
Fort Worth, TX - USA
Monthly Salary:
Not Disclosed
Posted on:
25 days ago
Vacancies:
1 Vacancy
Job Summary
Schedule: PRN
Your experience matters
How youll contribute
A Utilization Review Specialistwho excels in this role:
- Facilitates clinical reviews on all patient admissions and continued stays.
- Completes pre and re-certifications for inpatient and outpatient services. Reports appropriate denial and authorization information to designated resource.
- Analyzes patient records to determine legitimacy of admission treatment and length of stay and interfaces with managed care organizations external reviews and other payers.
- Displays knowledge of clinical criteria managed care requirements for inpatient and outpatient authorization and advocates on behalf of patients with substance abuse dual diagnosis psychiatric or emotional disorders to managed care providers for necessary treatment.
- Contacts external case managers/managed care organizations for certification of insurance benefits throughout the patients stay and assists the treatment team in understanding the insurance companys requirements for continued stay and discharge planning.
- Works with DON to ensure documentation requirements are met
- Ensures appeals are completely thoroughly and on a timely basis
What were looking for
Applicants should have a Bachelors Degree required Masters degree preferred.
Additional requirements include:
- Previous utilization review experience in a psychiatric healthcare facility preferred
- Current unencumbered clinical license strongly preferred
- CPR certification and De-escalation Training required
More about WellBridge Healthcare Fort Worth
WellBridge Healthcare Fort Worthis a behavioral health hospitaloffering exceptional care to the Fort Worth TX community.
EEOC Statement
WellBridge Healthcare Fort Worth is an Equal Opportunity Employer.WellBridge Healthcare Fort Worthis committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment.
Required Experience:
IC
Key Skills
- Accounts Handling
- Access
- Commissioning
- Biotechnology
- Civil Engineering
- Health And Safety Management
About Company
Lifepoint Health is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 a ... View more
