Utilization Review Coordinator PRN

Behavioral Health Precertification Specialist

Three Rivers Behavioral Health is a 136-bed treatment facility that specializes in quality behavioral health and substance abuse services for adolescents and adults. We offer a full continuum of care through an integrated system of inpatient, partial hospitalization and intensive outpatient programs. Our team of 300+ high quality employees describe working here as "family atmosphere," "supportive leadership," and "life-changing." Progressive professionals in the fields of psychiatry, medicine, nursing, social services, and activity therapy serve hundreds of adults and adolescents each month with the common goal of creating new beginnings. Healthcare professionals have a unique opportunity to affect lives for the better each and every day. Choose Three Rivers and start your life-changing journey today.

This position is Per Diem, As Needed.

Job Duties:

• Provides precertification and verification of benefits for incoming patients.
• Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations/managed care companies.
• Discuss with patient various forms and obtain signatures from the patients.
• Complete insurance verification from various payors and obtain correct information to complete precertification as well as appeals.

Benefits:

• Career development opportunities across UHS and our 300+ locations!
• Diverse programming to expand your experience
• Employee Assistance Program
• SoFi Student Loan Refinancing Program
• Employee Referral Program

Qualifications:

• Education: Masters' degree in a recognized mental health field or Registered Nurse.
• Experience: Minimum of two years psychiatric experience in chart analysis and in the utilization review field.
• Excellent oral and written communication skills required in order to communicate in a clear and concise manner with patients, physicians, staff and payors.
• Knowledge of external review organizations, payor sources, financial planning and contracting (i.e., managed care, Medicare, Medicaid, etc.)
• Must be able to work in a fast-paced environment with frequent interruptions.

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.