Remote Utilization Review Specialist – Behavioral Health

MnAdultTeenChallenge; Minneapolis (MN); Híbrido; USD 37 000 - 41 000; Tempo integral

Resumo da oferta

Minnesota Adult & Teen Challenge in Minneapolis is seeking a Utilization Review Coordinator to obtain and maintain insurance authorizations for treatment services, collaborating with admissions, counselors, and payers to ensure timely approvals and compliance.

This hybrid role requires strong organization, attention to detail, and knowledge of ASAM Criteria and DHS requirements. Training is provided; initial in-person in Minneapolis with remote work thereafter.

Qualificações

• High school diploma or GED required; associate/bachelor's preferred.
• 2 years in utilization review, admissions, or related healthcare setting.
• Experience with insurance authorizations and payer requirements preferred.
• Experience in behavioral health or SUD settings preferred.
• Knowledge of DSM-5-TR, ASAM Criteria, and medical necessity standards.

Responsabilidades

• Obtains and maintains insurance authorizations for treatment services per payer requirements.
• Submits initial authorizations, continued stay reviews, and reauthorizations on time.
• Monitors status and renewals to prevent interruptions in care.
• Communicates determinations and payer requirements to clinical/operational teams.
• Supports documentation for medical necessity and level of care recommendations.

Conhecimentos

Organization

Time management

Communication

Problem solving

Confidentiality

HIPAA compliance

Formação académica

High school diploma or GED

Associate's or Bachelor's degree preferred

LADC credentials preferred

Ferramentas

Credible EMR

Descrição da oferta de emprego

Minnesota Adult & Teen Challenge in Minneapolis is seeking a Utilization Review Coordinator to obtain and maintain insurance authorizations for treatment services, collaborating with admissions, counselors, and payers to ensure timely approvals and compliance.

This hybrid role requires strong organization, attention to detail, and knowledge of ASAM Criteria and DHS requirements. Training is provided; initial in-person in Minneapolis with remote work thereafter.