Utilization Review Coordinator – Psychiatric Care

Universal Health Services, Inc.; Augusta (GA); On-site; USD 60,000 - 90,000; Full time

Benefits offered by this job

Referral Bonus Program

Competitive Compensation

Generous Paid Time Off

Excellent Medical, Dental, Vision

Job summary

Lighthouse Care Center of Augusta is seeking a dedicated Utilization Review Coordinator to join our Lighthouse Case Management team in Augusta, GA. The role focuses on coordinating clinical content and ensuring high-quality, cost-effective treatment in line with Universal Health Services regulations.

Under the UR Manager, the coordinator conducts clinical review of data for pre-certification and continued stay reviews, liaising with physicians, staff, and insurance entities to secure approvals.

Qualifications

• Master's degree in social science field (social work, counseling, sociology, psychology).
• License-eligible or licensed in Georgia (LAPC, LPC, LMSW, LCSW, LMFT, LMHC).
• At least 2 years in a psychiatric health care setting, with utilization review experience.

Responsibilities

• Review clinical records and coordinate with treatment team to obtain data for insurance pre-certifications and ongoing authorization.
• Input pre-certifications and continued stay reviews into Midas; verify first-of-month insurance coverage; post patient payments in MS4.
• Glean clinical criteria and enter supporting data into systems; support UR tasks under UR Manager.

Skills

Utilization review

Clinical coordination

Pre-certification

Education

Master's degree in social science

Job description

Lighthouse Care Center of Augusta is seeking a dedicated Utilization Review Coordinator to join our Lighthouse Case Management team in Augusta, GA. The role focuses on coordinating clinical content and ensuring high-quality, cost-effective treatment in line with Universal Health Services regulations.

Under the UR Manager, the coordinator conducts clinical review of data for pre-certification and continued stay reviews, liaising with physicians, staff, and insurance entities to secure approvals.