Mental Health Utilization Specialist

Ocean View Psychiatric Hospital; Long Beach (CA); On-site; USD 36,000 - 39,000; Full time

Benefits offered by this job

Medical, Dental, Vision Insurance

401(k) retirement savings plan

Team-oriented environment

Professional growth opportunities

Job summary

Ocean View Psychiatric Hospital seeks an experienced Utilization Review professional in Long Beach, CA. The role focuses on reviewing clinical documentation, medical necessity, and insurance authorizations for inpatient and outpatient care, coordinating with payers and the clinical team.

Candidates should have strong clinical judgment, English proficiency, and at least two years in behavioral health or hospital settings.

Qualifications

• High School Diploma or GED required.
• ICD-10 coding knowledge or certification.
• Billing and coding knowledge or certification.
• Medical records knowledge or certification.
• Ability to interact and communicate with patients, staff, and public.
• English reading/writing proficiency.
• Minimum two years in behavioral health, healthcare, or hospital settings.
• Strong teamwork across disciplines.

Responsibilities

• Review clinical documentation and medical necessity.
• Communicate with insurance companies.
• Coordinate care with payers, providers, and clinical team.
• Submit TAR forms accurately and timely.
• Maintain payer records and track submissions.
• Support inpatient and outpatient services as needed.

Skills

Insurance eligibility

Medical records

EHR systems

Communication

Teamwork

Computer literacy

Education

High School Diploma or GED

ICD-10 Coding Knowledge

Billing and Coding Knowledge

Medical Records Knowledge

Tools

EHR systems

Job description

Ocean View Psychiatric Hospital seeks an experienced Utilization Review professional in Long Beach, CA. The role focuses on reviewing clinical documentation, medical necessity, and insurance authorizations for inpatient and outpatient care, coordinating with payers and the clinical team.

Candidates should have strong clinical judgment, English proficiency, and at least two years in behavioral health or hospital settings.