ABA Utilization Review Specialist

🔥 6 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 12%

What it means: the chance that no one is really hiring for this job.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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Spectrum Billing Solutions

WebsiteLinkedInAll Job Openings

51 - 200 employees

🏥 Healthcare

💼 Consulting

🛡️ Insurance

Healthcare • Consulting • Insurance

Spectrum Billing Solutions is a company that offers industry-leading revenue cycle management services tailored for healthcare providers. They provide a comprehensive suite of services including verification of benefits, utilization review, billing, insurance collections, and patient collections. Spectrum is renowned for its ability to maximize reimbursement through persistent claims management and its strong focus on customer service. Their innovative dashboard reporting further empowers clients to make informed decisions and improve operations. With a focus on customization and efficiency, Spectrum Billing Solutions acts as a strategic partner to its clients, aiming to enhance their financial standing and streamline their operations.

📋 Description

• Review patient admission and clinical information to ensure medical necessity and compliance of utilization review guidelines • Obtain initial and continuing authorization for treatment services • Manage authorization denials including referral for peer review • Document and record all necessary information • Monitor and track new and ongoing authorization cases • Collaborate and communicate with clinical staff to ensure necessary information is obtained and timely reviews are performed • Assist external clients in understanding payer requirements for authorizations • Participate in team meetings • Maintain confidentiality of patient information and adhere to HIPAA regulations

🎯 Requirements

• 3-5 years of Utilization Review experience • ABA and/or Behavioral Health experience preferred • Bachelor’s or master’s degree preferred • Superior written and oral communication skills • Attention to detail to ensure necessary information is captured and properly documented • Ability to work independently and within a team • Ability to multi-task, prioritize and meet expected deadlines • Solid understanding of insurance benefits and coverages • Strong computer skills (Word, Excel, billing software)

🏖️ Benefits

• Flexible work environment • Competitive Salary • A close-knit team of talented and skilled individuals • Growth opportunities • Medical benefits • Dental benefits • Vision benefits • Flexible Paid Time Off • 401K with Company match • Supplemental Benefits

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