Utilization Review Coordinator — Admissions & Insurance Specialist

Pyramid Healthcare Inc; Pennsylvania; Hybrid; USD 28,000 - 33,000; Full time

Job summary

Pyramid Healthcare Inc. seeks a healthcare professional to perform utilization review reviews and manage eligibility in a fast-paced behavioral health setting in Pennsylvania.

You will maintain UR databases, coordinate with billing, ensure ASAM requirements are met, and work with referral sources to optimize funding.

Qualifications include 3–5 years in Utilization Review, an Associate or Bachelor's in Behavioral Health, and strong Excel/Office skills. Starting compensation is $20/hour.

Qualifications

• 3–5 years’ experience in Utilization Review or related position in a healthcare setting.
• Strong computer skills including intermediate Excel and Word.

Responsibilities

• Perform admission, continued stay and discharge reviews on all managed care clients.
• Maintain positive relationships with referral sources and insurance companies.
• Track admissions, continued stay and discharge ASAM requirements for county referrals.
• Maintain and participate in chart reviews to ensure proper paperwork is in place.
• Work directly with Billing Department to reduce uncovered days of funding and recuperate lost days.
• Report to the Assessment Manager on a weekly basis.

Skills

Utilization Review experience

Education

Associate Degree or equivalent

Bachelor of Science in Behavioral Health

Tools

Excel

Navinet

Job description

Pyramid Healthcare Inc. seeks a healthcare professional to perform utilization review reviews and manage eligibility in a fast-paced behavioral health setting in Pennsylvania.

You will maintain UR databases, coordinate with billing, ensure ASAM requirements are met, and work with referral sources to optimize funding.

Qualifications include 3–5 years in Utilization Review, an Associate or Bachelor's in Behavioral Health, and strong Excel/Office skills. Starting compensation is $20/hour.