Utilization Review Coordinator - 4-Month Assignment

Odyssey-Behavioral-Healthcare; Franklin (TN); On-site; USD 39,000 - 52,000; Full time

Benefits offered by this job

Continuing education & certification

Company matched 401K

Company paid EAP

Job summary

Odyssey Behavioral Healthcare, LLC seeks a Utilization Review Coordinator for a 4-month assignment across the EST and CST time zones. You will monitor utilization, perform pre-certifications, continued stay reviews, and discharge planning to ensure appropriate care and alignment with payer contracts.

Collaborating with revenue cycle, admissions, facility leadership, and clinical teams, you will input authorization statuses in EMR systems and assist with appeals as needed.

Qualifications

• Bachelor’s degree and 1 year clinical experience in a mental health facility.
• Valid driver’s license and vehicle insurance.
• Experience with EMR systems is desirable.

Responsibilities

• Setting reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts.
• Conducts initial pre-certification authorizations, continued stay reviews, care coordination, and discharge planning for appropriateness of treatment.
• Assesses the medical necessity of client appropriateness of treatment setting to determine the level of care required.
• Facilitates member care transition through the healthcare continuum and refers treatment plans/plan of care to clinical reviewers as required.
• Inputs and maintains authorization status in the appropriate EMR systems for billing purposes.
• Consults with clinical reviewers and/or medical directors to ensure medically appropriate, high quality, care throughout the medical management process.
• May manage appeals for services denied.

Skills

Clinical experience

Education

Bachelor’s degree

Job description

Odyssey Behavioral Healthcare, LLC seeks a Utilization Review Coordinator for a 4-month assignment across the EST and CST time zones. You will monitor utilization, perform pre-certifications, continued stay reviews, and discharge planning to ensure appropriate care and alignment with payer contracts.

Collaborating with revenue cycle, admissions, facility leadership, and clinical teams, you will input authorization statuses in EMR systems and assist with appeals as needed.