Utilization Review Coordinator: Benefits & Care Coordination

Three Rivers Behavioral Health; West Columbia (SC); On-site; USD 60,000 - 75,000; Full time

Benefits offered by this job

Career development

Diverse programming

Competitive compensation

Medical, Dental, Vision

Employee assistance

401K match

Tuition assistance

Employee referral

Job summary

Three Rivers Behavioral Health in West Columbia, SC is seeking a professional to perform precertification and benefits verification for incoming patients. The role coordinates utilization management with the treatment team and external review organizations to ensure proper approvals and payor communication.

Qualified candidates hold a Masters in a mental health field or RN license, with at least two years of psychiatric chart review and utilization experience.

Qualifications

• Masters in mental health field or RN is required.
• Minimum of two years psychiatric experience in chart analysis and utilization review.
• Knowledge of external review organizations, payor sources, and managed care contracts.
• Ability to communicate clearly with patients, staff, and payors.

Responsibilities

• Precertification and verification of benefits for incoming patients.
• Coordinate utilization management with the treatment team and external review orgs.
• Discuss forms with patients and obtain signatures.
• Complete insurance verification and precertification as well as appeals.

Skills

Psychiatric chart review

Utilization review

Interdisciplinary collaboration

Education

Masters degree in mental health field

Registered Nurse (RN)

Job description

Three Rivers Behavioral Health in West Columbia, SC is seeking a professional to perform precertification and benefits verification for incoming patients. The role coordinates utilization management with the treatment team and external review organizations to ensure proper approvals and payor communication.

Qualified candidates hold a Masters in a mental health field or RN license, with at least two years of psychiatric chart review and utilization experience.