UR COORDINATOR - PRN

Utilization Review Coordinator

Meridell Achievement Center is a 134-bed, seclusion free, psychiatric residential treatment facility located northwest of Austin. Our 60-acre campus is complete with mature oaks, rolling hills, and plenty of walking paths and outdoor spaces. We provide 24-hour psychiatric care to girls and boys ages 10 to 17 years old with customized therapeutic approaches and intensive behavioral programs to teach young patients to moderate their behavior, manage emotions and improve social functioning.

We are looking for a detail oriented per-diem (PRN) Utilization Review Coordinator to pick up shifts as necessary, Monday through Fridays. Flexible hours.

Job Description

The Utilization Review Coordinator is responsible for bridging communications between the hospital treatment team and insurance company/referral agencies. Will analyze clinical documentation to submit prior authorization requests to insurance companies for approval prior to admitting a patient and submit concurrent review applications to extend a patient's stay, to ensure they receive appropriate services. All authorization extensions or denials must be tracked in an expedient fashion in the electronic system, and follow appeals process for denials. Peer reviews, consults, and appeals between facility physician and insurance physician. In addition, will review medical record and clinical documentation for medical necessity. The UR Coordinator will work closely with numerous departments including admissions, accounts receivable, and the clinical team, as such this position is based in the facility office.

Job Duties

• Review clinical documentation for medical necessity
• Submit clinical documentation to third party payers
• Schedule peer reviews, consults, and appeals
• Communicate with family and treatment team insurance authorizations and denials
• Submit appeals and justifications
• Work effectively with multiple departments

Benefit & Rewards Highlights

Challenging and rewarding work environment Competitive compensation & generous paid time off Excellent medical, dental, vision and prescription drug plans 401(K) with company match and discounted stock plan SoFi student loan refinancing program Tuition savings to continue your nursing education with Chamberlain University Career development opportunities within UHS and its 300+ subsidiaries! Pet insurance

Qualifications

Education/Training: B.S. Nursing from an accredited school of nursing, LPC, LCSW, or LMFT. Experience: One year inpatient psychiatric experience with adults, adolescents and/or children preferred. Licensure/Certification: Current Texas Registered Nurse License, LPC, LCSW, or LMFT. Current Driver's License Knowledge and Skills: Full understanding of medical terminology, insurance terminology, and clinical / psychiatric disorders. Time Management: flexible and able to assess the priorities of the department on a daily basis. Communication and analytical skills. Attention to detail and proficient with computers. Personal accountability is necessary to meet high service excellence standards. Must be able to pass a thorough background check. 21 years or older.

EEO Statement All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

Universal Health Services