Utilization & Coverage Support Specialist

Summit BHC; Williamsburg (VA); On-site; USD 40,000 - 55,000; Full time

Benefits offered by this job

Comprehensive benefit plan

Competitive salary

Job summary

Summit BHC is seeking a Utilization Assistant for The Pavilion at Williamsburg Place in Virginia. This role involves supporting utilization review activities to ensure accurate reimbursement and coverage for patients while coordinating with insurance providers.

The ideal candidate will have experience in a clinical setting and be proficient in manage care processes. Joining Summit BHC means becoming part of a mission focused on serving Veterans and their families.

Qualifications

• 1+ years of direct clinical experience in a psychiatric or mental health setting preferred.
• Experience in utilization management tasks and working with insurance providers.
• Excellent communication skills for interacting with patients and payers.

Responsibilities

• Assist with pre-certifications and admission benefit verification.
• Review medical records for appropriateness of level of care.
• Conduct timely reviews with payers for certification of care.

Skills

Pre-certification of care

Benefit verification

Insurance communication

Education

High School Diploma

Bachelor’s Degree in social work, behavioral or mental health

Job description

Summit BHC is seeking a Utilization Assistant for The Pavilion at Williamsburg Place in Virginia. This role involves supporting utilization review activities to ensure accurate reimbursement and coverage for patients while coordinating with insurance providers.

The ideal candidate will have experience in a clinical setting and be proficient in manage care processes. Joining Summit BHC means becoming part of a mission focused on serving Veterans and their families.