Utilization & Reimbursement Specialist

Harboroaks; Riverdale (GA); On-site; USD 45,000 - 60,000; Full time

Job summary

Harboroaks in Riverdale, Georgia, is seeking a dedicated professional to monitor patient services and optimize reimbursement for the facility. The role involves acting as a liaison between managed care organizations and clinical staff, reviewing insurance plans, and ensuring quality of services.

A high school diploma is required, with preferred degrees in social work or related health fields. Clinical experience is essential, and relevant licenses within the state are preferred. Join us in maintaining high-quality patient care while contributing to the team's success.

Qualifications

• Required education includes high school diploma or equivalent.
• Preferred education is an associate's, bachelor's, or master's degree in a related health field.
• Clinical experience or two or more years' experience working with the facility's population is needed.

Responsibilities

• Act as a liaison between managed care organizations and clinical staff.
• Conduct reviews of insurance plans and coordinate communication on reimbursement requirements.
• Monitor patient length of stay and inform staff on related issues.

Skills

Clinical experience

Communication skills

Organizational skills

Education

High school diploma or equivalent

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

Job description

Harboroaks in Riverdale, Georgia, is seeking a dedicated professional to monitor patient services and optimize reimbursement for the facility. The role involves acting as a liaison between managed care organizations and clinical staff, reviewing insurance plans, and ensuring quality of services.

A high school diploma is required, with preferred degrees in social work or related health fields. Clinical experience is essential, and relevant licenses within the state are preferred. Join us in maintaining high-quality patient care while contributing to the team's success.