Utilization Review Coordinator - PRN position

Georgetown Behavioral Health Institute; Georgetown (TX); On-site; USD 52,000 - 78,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Disability coverage

401(k)

Paid time off

Job summary

Georgetown Behavioral Health Institute seeks a PRN Utilization Review Coordinator for our inpatient behavioral health hospital. The role involves coordinating with insurance companies for initial, concurrent, and retrospective authorizations for inpatient, partial, and intensive outpatient services.

Education and experience: Bachelor's degree in nursing or equivalent preferred; 3–5 years in admitting or financial counseling preferred; knowledge of insurance coverage and billing practices.

Qualifications

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

Responsibilities

• Obtain authorization for admitted patients.
• Review and monitor the authorization process to proactively identify problems.
• Coordinate with insurance and managed care systems to secure timely authorizations.

Skills

Utilization Review

Education

Bachelor's degree in nursing or equivalent

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.