Part-Time Utilization Review Coordinator

Universal Hospital Services Inc.; Titusville (FL); On-site; USD 28,000 - 50,000; Part time

Benefits offered by this job

Medical plan

Dental plan

Vision plan

401(k) match

Tuition benefits

Pet insurance

SoFi student loans

Job summary

Palm Point Behavioral Health in Titusville, FL is seeking a Part Time Utilization Review (UR) Coordinator to monitor and coordinate documentation and authorization for inpatient and outpatient services, ensuring appropriate utilization and timely precertifications.

The UR Coordinator reviews admission decisions, coordinates with treatment teams and external payors, handles appeals and retrospective reviews, and supports high-quality patient care through accurate documentation and communication.

Qualifications

• Education: Associate Degree in Nursing or Bachelor's Degree in social work, mental health or related field from accredited college or university required.
• Experience: A minimum of two (2) years’ experience in health care case management or utilization review, psychiatric or mental health setting required.
• Certification: Current, Valid State License (RN, LCSW, LMHC, or LMFT) Preferred.

Responsibilities

• Review clinical content of medical records, participate in treatment team meetings, and collaborate with physicians, therapist, nurses and pertinent staff on gathering the necessary data to communicate with insurance companies/authorizing entities to ensure initial precertification and continued authorization is achieved.
• Ensure input of pre-certifications and continued stay reviews into Midas, follow-up on unfinished pre-certifications from the day before, coordinate with the treatment team on any follow-ups necessary, verify insurance coverage at the first of the month, and post patient payments into MS4.
• Trained in all aspects relative to timely gathering of clinical criteria, communication of clinical criteria, and entry of supporting clinical criteria into computer based systems, in addition to other job duties.

Skills

Healthcare case management

Utilization review

Education

Associate Degree in Nursing

Bachelor's Degree in social work/mental health or related field

Job description

Palm Point Behavioral Health in Titusville, FL is seeking a Part Time Utilization Review (UR) Coordinator to monitor and coordinate documentation and authorization for inpatient and outpatient services, ensuring appropriate utilization and timely precertifications.

The UR Coordinator reviews admission decisions, coordinates with treatment teams and external payors, handles appeals and retrospective reviews, and supports high-quality patient care through accurate documentation and communication.