Utilization Review Specialist Position Available In Palm Beach, Florida

Utilization Review Specialist Diamond Recovery – 3.0 Boca Raton, FL Job Details Full-time $50,000 – $65,000 a year 7 hours ago Benefits Health insurance Dental insurance 401(k) Paid time off Vision insurance Life insurance Qualifications Behavioral health hospital experience Addiction counseling Utilization review HIPAA Mid-level High school diploma or GED Bachelor’s degree Utilization management Addiction medicine Medical billing Computer networking EMR systems Associate’s degree Communication skills Time management Full Job Description The Utilization Review Associate performs a variety of functions, including but not limited to, assisting in navigating electronic medical records and advocating for the patient; Communicating with insurance carriers via phone/ fax/email as needed. Responsibilities and Duties Learn and assist in efficiently managing the admission to discharge process for clients at assigned facilities. Clearly communicate medical necessity using appropriate medical terminology to secure authorizations Ensure meticulous attention to detail and execute tasks with precision in all responsibilities, striving for the highest standards of quality. Ability to adhere to HIPPA compliance standards Collaborate effectively with team members to resolve authorization requests within allocated timeframes. Proficient in personal time management, multi-tasking and calendar organization Accurately compile medical records and ensure timely dispatch. Perform effective follow-up activities through payer web portals, phone, and other computerized methods. Qualifications and Skills Experience and knowledge of Out Of Network (OON) insurance benefits Basic understanding of the utilization review process Familiar with ASAM / and or medical necessity criteria for each level of care Effective communication skills, both verbal and written via phone and email Knowledge in computers and can navigate various software programs Education and Experience Relevant experience working in healthcare setting High-school diploma Associate’s degree or higher in Psychology or related field Related Certification or Credential (Case Manager, CAC, CAP, SW, etc.) Knowledge in day-to-day operations of a behavioral health care setting Knowledge of the Substance Abuse Facility utilization review process Knowledge of all levels of care (Detox, RTC, PHP, IOP, Aftercare) Experience working within a medical billing or utilization review setting Experience working withing mental health or behavioral healthcare setting Experience utilizing related software programs such as

Kipu Job Type:

Full-time Pay:

$50,000.00 – $65,000.00 per year

Benefits:

401(k) Dental insurance Health insurance Life insurance Paid time off Vision insurance

Schedule:

8 hour shift Monday to Friday Ability to

Commute:

Boca Raton, FL 33433 (Required) Ability to

Relocate:

Boca Raton, FL 33433: Relocate before starting work (Required)

Work Location:

In person