Texas Grant Utilization Reviewer

Job Description

Job Description

Description:

  Schedule: Monday - Friday 5:30am-1:30pm 

Community Medical Services (CMS) is hiring a Texas Grant Utilization Reviewer. Under the supervision of the Regional Operations Director, the Texas Grant Utilization Reviewer is responsible for monitoring Texas Grant Funded Client Tracker to ensure current client census is reflected, removing clients that have been discharged in a timely manner, and checking due dates and missing documentation for each client on funding and communicating updates needed to responsible staff and management.

  This position will travel to multiple CMS sites.

As part of our mission to help individuals recover from substance use disorders, you’ll thrive in a supportive, engaging, and fulfilling work environment where your contributions are valued.

Along the way, we’ll invest in your well-being through a benefits package that includes:

• Subsidized medical, dental, and vision insurance
• Health savings account
• Short and long-term disability insurance
• Life insurance
• Paid sick, vacation, and holiday time
• 401K retirement plan with match
• Tuition and CME reimbursement up to 100%
• Employee assistance program to support your mental health and wellness
• Ongoing professional development 

Responsibilities:

• Monitoring Texas Grant Funded Client Tracker to ensure current client census is
• reflected, removing clients that have been discharged in a timely manner, and
• checking due dates and missing documentation for each client on funding and
• communicating updates needed to responsible staff and management (KC)
• Completing Daily Capacity Reports in CMBHS for each service location to
• ensure slots are not over capacity for funding and sending to Regional Director 
• Running Methasoft reports to compare against census, informing staff of
• discrepancies to resolve in timely manner including newly funded clients that need a
• change in billing episode. 
• Running GRPA reports weekly from CMBHS and sending them directly to managers
• showing which staff are due/overdue to increase compliance. (Have not run report
• from CMBHS, I’ve been checking each client’s chart) Run Report Called GPRA Client
• due for assessment.
• Attending monthly GRPA webinar update
• Assisting other staff in trouble shooting errors, issues with service locations, revising
• documentation, etc.
• Responsible for making contact in person or over phone to complete updated
• Financial Eligibility with client (will make 3 attempts and document each prior to
• communicating need for other staff to assist with process.
• Documenting all services provided to client 

Skills:

• Ability to communicate clearly and effectively between all organizational levels and with outside providers 
• Advanced computer knowledge, including ability to navigate in electronic health records 
• General knowledge and aptitude for working independently with adults of mixed ethnic groups 
• Culturally competent and sensitive to client and employee needs 
• Excellent organizational skills, accuracy, and attention to detail 
• Problem solving, conflict resolution, time management, and strong customer service skills 
• Strong team player comfortable working in a fast-paced setting 
• Ability to maintain confidentiality to ensure compliance with HIPAA and 42 CFR, Part 2 
• Flexible with the ability to work in a continuously changing environment

Education, Certification, and Experience Requirements:

• High School diploma required plus relevant insurance verification experience
• 2+ years of front desk experience, preferably at hospital front desk or multi-physician practice 
• Proficient in an electronic medical record required, along with Microsoft Office Suite programs 
• Excellent organizational, problem-solving, time management and interpersonal skills

Tools and Equipment:

• The ability to use a phone, computer, printer, and copier is required.
• Frequent use of Microsoft office products, including but not limited to Outlook, Word, Excel, and PowerPoint.
• Frequent use of electronic health record to document patient encounters. 

Physical Working Conditions and Office Setting Description:

• Ability to travel to assigned CMS sites (only keep if applicable) 
• Prolonged sitting, standing, frequent bending, stooping, or stretching associated with an office environment 
• Frequent and prolonged typing and operation of computer, keyboard, and telephones

#CLSTF

About Community Medical Services

Community Medical Services (CMS) is a CARF-accredited addiction treatment program providing services in the form of outpatient medication-assisted treatment and one-on-one and group counseling to those seeking help with their opioid use disorder. Headquartered in Arizona with more than 70 treatment clinics in 14 states, CMS is dedicated to meeting the challenges presented by the growing opioid epidemic in communities where treatment is lacking.

Our Commitment

We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, sex, disability status, sexual orientation, gender identity, age, protected veteran status or any other characteristic protected by law. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.

Other Conditions

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.