Utilization Review Coordinator - Behavioral Health

Behavioral Health System, Inc.; Memphis, Northern (TN, KY); Hybrid; USD 65,000 - 80,000; Full time

Job summary

Lakeside Behavioral Health System in Memphis, TN seeks an UM Coordinator who can assess psychiatric diagnoses, determine appropriate level of care, and advocate for patient length of stay and benefits. You’ll work with hospital teams and insurers to optimize reimbursement while coordinating physician staffing and outpatient billing processes.

Ideal candidates have 3–5 years of psychiatric care experience, a relevant Masters or RN license, and strong analytical and communication skills to

Qualifications

• Masters prepared healthcare professional (Nursing, Counseling, Psychology or SocialWork) or RN.
• 3–5 years direct psychiatric patient care experience.
• TN RN license, LCSW, or LPC preferred.
• Knowledge of psychiatric care, utilization review and insurance reimbursement.

Responsibilities

• Evaluate patient medical records to determine illness severity and level of care.
• Serve as liaison for patients and hospital with insurance companies.
• Oversee utilization review activities to ensure reimbursement.
• Facilitate physician weekly staffing meetings and coordinate billing with outpatient offices.
• Manage patient benefits and understand levels of care offered.

Skills

Analytical skills

Organizational skills

Verbal communication

Written communication

Advanced computer skills

Education

Masters prepared healthcare professional

Tools

None

Job description

Lakeside Behavioral Health System in Memphis, TN seeks an UM Coordinator who can assess psychiatric diagnoses, determine appropriate level of care, and advocate for patient length of stay and benefits. You’ll work with hospital teams and insurers to optimize reimbursement while coordinating physician staffing and outpatient billing processes.

Ideal candidates have 3–5 years of psychiatric care experience, a relevant Masters or RN license, and strong analytical and communication skills to