Utilization Review Specialist

🔥 18 minutes ago

🇺🇸 United States – Remote

💵 $50k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Advanced Recovery Systems, LLC

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2014

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

Advanced Recovery Systems, LLC is presented on its website as a company that assists with health insurance matters and related administrative support. The site text states "Health insurance is changing, but your health can’t wait. Call (352) 771-2700 and let us handle it for you," indicating the company provides help navigating insurance or managing insurance-related tasks for callers. The website also includes cookie/consent management and location search features, suggesting a consumer-facing service with multiple locations. Limited public text is available, so this description is conservative and based primarily on the provided site excerpt.

📋 Description

• Complete pre-authorizations, concurrent reviews, and internal utilization review reviews • Consult with multidisciplinary treatment team members concerning information required for concurrent reviews • Schedule peer-to-peer reviews and coordinate urgent/expedited appeals • Staff individual cases with physicians as needed • Follow Utilization Review Department policies and procedures • Utilize the UR Census Report daily • Make all initial calls within 24 hours and follow-up calls every 24 hours • Perform data entry and records management • Assist with the appeals process • Complete detailed daily documentation • Work with the Finance Department regarding client service authorizations • Communicate frequently with the treatment team • Perform other duties as assigned

🎯 Requirements

• Bachelor’s degree in a health or behavioral health related field required, or High School diploma or equivalent and a State license (e.g., Registered Nurse, Licensed Practical Nurse, LCSW, LMHC) preferred • Graduate degree in a health or behavioral health related field preferred • Minimum of three years’ experience working in a psychiatric or chemical dependency setting • Minimum of three years’ Utilization Review experience preferred • State licensure preferred (Registered Nurse, Licensed Practical Nurse, Licensed Clinical Social Worker, Licensed Mental Health Counselor) • Proficiency in establishing and maintaining positive and effective communication with managed care companies • Ability to align medical and counseling staff to ensure services are provided at the appropriate level of care in a timely manner consistent with the patient’s condition and in compliance with governmental and accrediting agencies • Knowledge of concurrent reviews, utilization review, census reports, and ASAM criteria • Ability to be resourceful and proactive in dealing with issues that may arise • Ability to organize, multitask, prioritize, and work under pressure • Effective time management

🏖️ Benefits

• Starting pay $50,000/yr, based on experience • Paid Time Off: Up to 2 weeks of paid time off per year plus sick pay & holiday pay • Benefits begin on the 1st day of the month following date of hire • Matching HSA - up to $1500/yr contribution from the company to your HSA • 401(k) • Medical, dental, and vision insurance • Free Telehealth access • Employee Referral Bonus - you can earn up to $4000