Utilization Review Coordinator

Overview 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 have 7 unique living units separated by gender, age, and development needs, a swimming pool, gymnasium, sports court and playing fields. 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. Website: Job Title Utilization Review Coordinator (Per-Diem) Job Description The Utilization Review Coordinator is responsible for bridging communication between the hospital treatment team and insurance companies or referral agencies. The coordinator will analyze clinical documentation to submit Prior Authorization requests, manage concurrent review applications, and ensure proper services are provided. All authorization extensions or denials must be tracked in the electronic system and appeals processed. The role involves peer reviews, consults, appeals between the facility physician and insurance physician, and reviewing records for medical necessity. The coordinator works closely with admissions, accounts receivable, and the clinical team and is based in the facility office. Responsibilities 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 regarding 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 More information available on the Benefits Guest Website 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 priorities of the department on a daily basis Communication and analytical skills Attention to detail and proficiency with computers Personal accountability 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 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. #J-18808-Ljbffr