Utilization Review Specialist

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $45k - $55k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 0%

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Compass Health Center

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2011

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

Compass Health Center is a specialized mental health care provider that offers immediate access to comprehensive, age-based programs for children, teens, young adults, and adults. They operate in multiple locations, including Illinois, Maryland, Virginia, and Washington D. C. , with both in-person and virtual care options. Their services include Partial Hospitalization (PHP) and Intensive Outpatient (IOP) programs, outpatient psychiatry, and specialized treatment programs for conditions like anxiety, OCD, trauma, and depression. The Center focuses on delivering quick, flexible, and evidence-based mental health solutions without the need for emergency room visits or inpatient hospitalizations.

📋 Description

• Contact insurance companies to verify insurance coverage and obtain approval of treatment recommended by the clinical team • Collaborate with the clinical team to compile treatment plans and supporting clinical documentation • Work with internal departments, including Revenue Cycle and Patient Advocates • Accurately document electronic medical records to reflect approval or denial of treatment authorization • Communicate insurance authorizations, denials, and insurance needs to appropriate internal staff • Schedule and deliver concurrent authorization reviews as required by individual insurance companies • Coordinate physicians’ reviews and appeals • Act as liaison between the clinical team and insurance companies • Facilitate and maintain insurance approval throughout patients’ treatment • Advocate on behalf of patients to overcome financial barriers to treatment

🎯 Requirements

• Bachelor’s Degree (preferred) or relevant experience • Previous healthcare or insurance experience • Knowledge of medical terminology and psychiatric criteria • Ability to analyze and communicate clinical information from progress, group, and psychiatric chart notes • Ability to work autonomously and independently while collaborating as part of a team • Ability to think critically and make decisions within individual role and responsibility • Strong written and verbal skills • Strong organizational and time management skills with ability to manage workload independently • Ability to foster and maintain positive external and internal relationships • Familiarity with Microsoft Office, Outlook, and EMR

🏖️ Benefits

• Comprehensive medical, dental, and vision plans • 401k program with company matching • Generous PTO • Competitive parental leave after 1 year of employment • Continuous training through CEU seminars • Volunteering opportunities • Opportunities for growth and continuous development within the organization