Utilization Review Coordinator - PRN position

Georgetown Behavioral; Georgetown (TX); On-site; USD 60,000 - 80,000; Full time

Benefits offered by this job

Full benefits package

Job summary

Georgetown Behavioral seeks a PRN Utilization Review Coordinator to manage authorizations for inpatient and related services. You will work with insurers to secure initial, concurrent, and retrospective approvals while supporting patient access to benefits.

We value candidates with UR or case management experience, nursing education, and knowledge of billing practices to navigate complex insurance requirements effectively.

Qualifications

• Bachelor’s degree or equivalent in nursing preferred.
• 3-5 years Admitting or Financial Counseling preferred.
• Two years clinical experience in a facility with medical terminology and acute psychiatric inpatient care criteria is preferred.
• Knowledgeable of insurance coverage and billing practices preferred.
• Previous experience in utilization review or case management desirable.

Responsibilities

• Obtain authorization for each admitted patient through UR processes.
• Review and monitor authorization steps to identify problems and help patient access benefits.
• Coordinate with insurers and care teams for initial, concurrent and retrospective reviews.
• Ensure compliance with facility policies and payer requirements.

Skills

Utilization review experience

Financial counseling

Admitting experience

Education

Bachelor's degree or equivalent 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.