Utilization Review Coordinator - PRN position

Georgetown Behavioral Health Institute; Georgetown (TX); On-site; USD 41,000 - 55,000; Full time

Job summary

Georgetown Behavioral Health Institute is seeking a PRN Utilization Review Coordinator to manage authorizations with insurance providers for inpatient, partial, and intensive outpatient services. The role requires coordination across admission teams and knowledge of billing practices.

Preferred candidates hold a Bachelor's degree in nursing and 3-5 years of admitting or financial counseling experience, with CPR certification within 30 days.

Qualifications

• Bachelor's degree or equivalent in nursing preferred.
• 3-5 years in admitting or financial counseling preferred.
• Knowledge of insurance coverage and billing practices preferred.
• Previous utilization review or case management experience desirable.
• CPR certification required within 30 days of hire.

Responsibilities

• Coordinate authorization for admitted patients with insurers and managed care.
• Review the authorization process to identify potential problems and ensure full benefits access.
• Assist with inpatient, partial, and intensive outpatient admissions and services.
• Work with clinical and admitting staff to facilitate timely approvals.

Skills

Insurance verification

Utilization review

Case management

Communication

Education

Bachelor's degree in nursing

Job description

Our inpatient behavioral health hospital is seeking a PRN Utilization Review Coordinator.

This position is responsible for working with insurance companies and managed care systems for the initial authorization, concurrent and retrospective review of inpatient, partial, and intensive outpatient admissions and services. Previous experience in utilization review or case management desirable.

This position will obtain authorization for each admitted patient. Review and monitor each step of the authorization process to proactively identify potential problems to help patients access the full range of their benefits through the utilization review process.

Education and/or Licensure - Bachelor's degree or equivalent in nursing preferred.

Experience - 3-5 years Admitting or Financial Counseling preferred. Prefer two years clinical experience in a facility with medical terminology and in criteria for acute psychiatric inpatient care. Knowledgeable of insurance coverage and billing practices preferred. Previous experience in utilization review or case management desirable.

Additional Requirements - Must possess or obtain a valid CPR certification and certified in facility approved verbal de-escalation and physical crisis management techniques within 30 days of hire and prior to completion of orientation required.

Full-time employees are eligible for medical, dental, vision, company paid disability, 401(k) and a generous amount of paid time off.