PRN Utilization Review Specialist Behavioral Health
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Job Location:
McKinney, TX - USA
Monthly Salary:
Not Disclosed
Posted on:
14 days ago
Vacancies:
1 Vacancy
Job Summary
Your experience matters
How youll contribute
AnUtilization Review Specialistwho excels in this role:
Displays knowledge of clinical criteria managed care requirements for inpatient and outpatient authorization and advocates on behalf of the patient to secure coverage for needed services
Completes pre and re-certifications for inpatient and outpatient services.
Reports appropriate denial and authorization information to designated resource.
Actively communicates with interdisciplinary team to acquire pertinent information and give updates on authorizations.
Participate in treatment teams to ensure staff have knowledge of coverage and to collect information for communication with agencies.
Works with DON to ensure documentation requirements are met.
Ensure appeals are completed thoroughly and on a timely basis.
Interface with managed care organizations external reviews and other payers.
Communicate with physicians to schedule peer to peer reviews.
Accurately report denials.
Why join us
We believe that investing in our employees is the first step to providing excellent patient addition to your base compensation this position also offers:
Healthy staffing levels
Flexible scheduling
Career growth
Competitive compensation
What were looking for
Applicants should have aBachelors degree (required) Masters degree preferred. Additional requirements include:
- Current unencumbered clinical license strongly preferred
- CPR and CPI Certification within 30 day of employment
- Previous utilization review experience in a psychiatric healthcare facility preferred.
Colling Springsis a 72-bed behavioral health hospitaloffering exceptional care to the McKinney TX community.
EEOC Statement
Collin Springsis an Equal Opportunity Employer.Collin Springsis 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
