Utilization Review Coordinator - Behavioral Health

Universal Health Services, Inc.; Memphis (TN); On-site; USD 60,000 - 90,000; Full time

Benefits offered by this job

Career development

Excellent benefits

401k with company match

Tuition assistance

Pet Insurance

Job summary

Lakeside Behavioral Health System is seeking an UM Coordinator to evaluate patient records, determine level of care, and liaise with insurance providers to ensure appropriate authorization and reimbursement.

The role requires a Master’s in a healthcare field or RN licensure, with 3–5 years of psychiatric patient care experience and strong analytical and organizational skills. This position is based on-site in Memphis and supports a broad range of psychiatric services.

Qualifications

• Master's prepared healthcare professional or Registered Nurse.
• 3–5 years direct psychiatric patient care experience.
• Knowledge of psychiatric care, utilization review, and insurance reimbursement procedures.

Responsibilities

• Evaluate patient medical records to determine severity of illness and appropriate level of care.
• Serve as liaison for patients and the hospital with insurance companies.
• Negotiate and advocate for patient length of stay and level of care.
• Oversee utilization review activities with other departments to ensure reimbursement for services provided by the hospital.
• Facilitate physician weekly staffing meetings and coordinate with outpatient offices for billing purposes.
• Manage patient benefits and ensure accurate billing and coding across departments.

Skills

Analytical skills

Organizational skills

Verbal and written communication

Education

Master’s degree or RN

Job description

Lakeside Behavioral Health System is seeking an UM Coordinator to evaluate patient records, determine level of care, and liaise with insurance providers to ensure appropriate authorization and reimbursement.

The role requires a Master’s in a healthcare field or RN licensure, with 3–5 years of psychiatric patient care experience and strong analytical and organizational skills. This position is based on-site in Memphis and supports a broad range of psychiatric services.