Healthcare Utilization & Reimbursement Specialist

Harboroaks; El Paso (TX); On-site; USD 45,000 - 60,000; Full time

Job summary

Harboroaks in El Paso, Texas is seeking a professional to monitor patient services and optimize facility reimbursements. The role involves clinical liaison duties, ensuring communication with managed care organizations, and supporting the admissions process.

Ideal candidates will possess a high school diploma; further education in health-related fields is preferred. Experience in clinical settings or utilization management will be essential for success in this position.

Qualifications

• Previous experience in utilization management preferred.
• Training in CPR, de-escalation, and restraint required.
• Preferred licensure includes LPN, RN, LMSW, LCSW, LPC.

Responsibilities

• Monitor patient length of stay and communicate on issues.
• Conduct quality reviews for medical necessity.
• Assist admissions with pre-certifications of care.
• Provide ongoing training for staff on documentation.

Skills

Clinical experience

Communication

Statistical analysis

Education

High school diploma or equivalent

Associate's, Bachelor's, or Master’s degree in Social Work, Nursing, or related field

Job description

Harboroaks in El Paso, Texas is seeking a professional to monitor patient services and optimize facility reimbursements. The role involves clinical liaison duties, ensuring communication with managed care organizations, and supporting the admissions process.

Ideal candidates will possess a high school diploma; further education in health-related fields is preferred. Experience in clinical settings or utilization management will be essential for success in this position.