Behavioral Health Utilization Review Coordinator

Universal Health Services, Inc.; Memphis (TN); On-site; USD 55,000 - 75,000; Full time

Job summary

Lakeside Behavioral Health System seeks a UM Coordinator to review psychiatric cases, determine appropriate levels of care, and liaise with insurers to secure appropriate reimbursement. The role supports physician staffing and coordinates with outpatient offices for billing.

The UM Coordinator will handle utilization review activities, apply knowledge of psychiatric care, and manage patient benefits across services across our 37-acre Memphis campus.

Qualifications

• Masters prepared healthcare professional (Nursing, Counseling, Psychology or SocialWork) or RN required.
• 3-5 years direct psychiatric patient care experience.
• Valid TN RN license, LCSW, or LPC preferred.
• Knowledge of psychiatric care, utilization review, insurance reimbursement procedures, DSM-V; advanced computer skills; strong analytical, organizational, verbal and written skills.

Responsibilities

• Evaluate patient medical records to determine severity of illness and level of care.
• Serve as liaison for patients and hospital with insurance companies.
• Negotiate and advocate for patient length of stay and level of care.
• Oversee utilization review activities with other departments to ensure reimbursement for services.
• Facilitate physician weekly staffing meetings and coordinate with outpatient offices for billing.
• Manage patient benefits.

Skills

Analytical skills

Organizational skills

Verbal communication

Written communication

Advanced computer skills

Education

Masters prepared healthcare professional or RN

Job description

Lakeside Behavioral Health System seeks a UM Coordinator to review psychiatric cases, determine appropriate levels of care, and liaise with insurers to secure appropriate reimbursement. The role supports physician staffing and coordinates with outpatient offices for billing.

The UM Coordinator will handle utilization review activities, apply knowledge of psychiatric care, and manage patient benefits across services across our 37-acre Memphis campus.