Utilization Review Pro: Mental Health Payer Liaison

View Behavioral Health; Long Beach (CA); On-site; USD 36,000 - 39,000; Full time

Benefits offered by this job

Medical, dental, vision insurance

401(k) retirement plan

Professional growth & training

Supportive team environment

Job summary

View Behavioral Health in Long Beach, CA seeks a Utilization Review professional to evaluate clinical documentation for insurance authorization and medical necessity. You will coordinate with payers, providers, and our clinical team to ensure appropriate levels of care.

The role requires strong clinical judgment, organization, and time management, with experience in inpatient/outpatient settings and EHR systems. On-site work with a supportive team and opportunities for growth are offered.

Qualifications

• High School Diploma or GED required.
• ICD-10 coding knowledge or certification.
• Billing and coding knowledge or certification.
• Ability to interact and communicate with seriously mentally ill patients, other staff, and the public.
• Ability to read/write in English.

Responsibilities

• Review clinical documentation and medical necessity for insurance authorization.
• Coordinate care with payers, providers, and clinical team.
• Maintain accurate patient and payer records.
• Submit TARs and track status and deadlines.
• Support inpatient and outpatient programs as needed.

Skills

Insurance eligibility

Documentation

EHR software

Communication

Education

High School Diploma or GED

Tools

EHR software

Billing software

Job description

View Behavioral Health in Long Beach, CA seeks a Utilization Review professional to evaluate clinical documentation for insurance authorization and medical necessity. You will coordinate with payers, providers, and our clinical team to ensure appropriate levels of care.

The role requires strong clinical judgment, organization, and time management, with experience in inpatient/outpatient settings and EHR systems. On-site work with a supportive team and opportunities for growth are offered.