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Registrar / Patient Service Representative
Aliso Viejo, CA

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Now viewing: UR Specialist - Per Diem
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Aliso Ridge Behavioral Health

UR Specialist - Per Diem

Job Description

DESCRIPTION OF POSITION
Work as member of multi-disciplinary treatment team reviewing patient care and treatment options for both inpatient and outpatient services. Proactively monitor and optimize reimbursement for external reviewers/third party payers.
KEY RESPONSIBILITIES
:
    Admissions:
    Conduct admission reviews.
      Concurrent/Stay Reviews:
      Conduct concurrent and extended stay reviews.
        Payment Appeals:
        Prepare and submit appeals to third party payers.
          Recordkeeping:
          Maintains appropriate records of the Utilization Review Department.
            Training:
            Provide staff in-service training and education.
            Minimum Requirements:
            Education and Licensing:
            • Current license as RN, LVN/LPT, or relevant Clinician, preferred.
            • Preferred; Master's degree in Social Work, Behavioral Science, or related field.
            • Current CPR certification recommended.
            Knowledge and Experience:
            • Demonstrated knowledge of health care service delivery systems and third-party reimbursement
            • Two or more years' experience working in managed care environment
            • Ability to apply and interpret admission and continued stay criteria
            • Strong understanding of admission and discharge function
            • Familiarity with medical terminology, diagnostic terms and treatment modalities
            • Knowledge of medical record-keeping requirements
            • Ability to comprehend psychiatric evaluations, consults, and lab results
            Skills and Abilities:
            • Maintains confidentiality of patients at all times.
            • Ability to cope well with stress and have a strong sense of compassion.
            • Sensitivity to and willingness to interact with persons of various social, cultural, economic and educational backgrounds.
            • Proficiency with software and/or equipment (Microsoft Office applications including Outlook, Word, Excel and PowerPoint).
            • Strong organizational skills with ability to prioritize projects, work relatively independently, manage multiple tasks, and meet deadlines.
            • Strong written and verbal communication skills.
            • Strong interpersonal skills: ability to work with people with a variety of background and educational levels.
            • Ability to work independently and as part of a team.
            • Good judgment, problem-solving and decision-making skills.
            • Demonstrated commitment to working collaboratively as well as possessing the skills to lead, influence, and motivate others.
            • Ability to work in a fast-paced, expanding organization.
            Physical Requirements :
            While performing the duties of this job, this position is frequently required to do the following:
            • Use standard office equipment and access, input, and retrieve information from a computer. Use computer keyboard with manual and finger dexterity and wrist-finger speed sufficient to perform repetitive actions efficiently for extended periods of time.
            • Communicate effectively in person or via telephone in a manner which can be understood by those with whom the person is speaking, including a diverse population.
            • Give and follow verbal and written instructions with attention to detail and accuracy.
            • Perform complex mental functions and basic arithmetic functions; interpret complex laws, regulations, and policies; collect, interpret, and/or analyze complex data and information.
            Vision:
            See details of objects at close range.
            • Coordinate multiple tasks simultaneously.
            • Reach forward, up, down, and to the side.
            • Sit or stand for minimum periods of one hour at a time and come and go from the work area repeatedly throughout the day.
            • Lift up to five (5) pounds.
            Job Type:
            Full-time Pay:
            $20.89 - $29.13 per hour
            Benefits:
            401(k) Dental insurance Disability insurance Employee assistance program Employee discount Flexible schedule Flexible spending account Health insurance Life insurance Paid time off Tuition reimbursement Vision insurance
            Work Location:
            In person