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Entry-Level JobVerifiedNo experience needed
Career Insights for Clinical Auditor / Utilization Reviewer
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Scorecard
Based on Missouri data
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What they do
A Clinical Auditor or Utilization Reviewer reviews the efficiency of healthcare delivery. Individuals tend to have had experience as a registered nurse or other healthcare delivery roles before transferring into this quality review role.
$94,243 / year median in Missouri
-9% projected decline
Job Description
Responsibilities About us Heartland Behavioral Health has been providing care for children and adolescents for over 100 years in Nevada, Missouri. We treat male and female patients ages 4 through 17 in both acuteas well as residential programsfor conditions ranging from depression, anxiety and other mood disorders to recovering from atraumatic event. All of our programs have been designed and tailored to help our patients grow and prosper. Heartland programs are provided with a focus on Trauma Informed Care. Heartland is nestled within 50 secluded acres in Nevada, Missouri, providing the perfect rural area setting for our residents to heal and grow. A reprieve from everyday life, our peaceful environment allows residents to return to the basics and reconnect with themselves and others. We also offer leisure activities, such as baseball, basketball and an equestrian program, that allow children and adolescents to enjoy themselves while building self-confidence, trust and teamwork.
JOIN OUR TEAM AND HELP US CHANGE LIVES!
This position provides support in utilization management and care coordination activities. Performs various duties related to working with families and referral sources for discharge processes and utilization management functions. Supports various insurance and financial counseling functions related to ensuring financial payments and follow-up paperwork completion.Benefit Highlights:
Excellent Medical, Dental, Vision and Prescription Drug Plans 401(K) with company match and discounted stock plan Educational reimbursement for qualified positions Loan Repayment Program Challenging and rewarding work environment Competitive Compensation & Generours Paid Time Off Career development opportunities SoFi Student Loan Refinancing Program Qualifications- Graduate of high school diploma or equivalent
- At least 2 years experience working in the mental health field, preferred.
- Specific experience in case management and/or utilization review.
- Strong working knowledge of insurance verification, medical necessity requirements for both acute and residential treatment and benefit plans.
- Individual will demonstrate an ability to utilize Microsoft Word, Excel and other hospital specific programs.
- Individual will be detail orientated and have an experience in providing quality customer service.
- Individual will possess a Bachelor's degree in a health related field and/or licensure as an LPN, LBSW, RN, LPC, LMSW, and LCSW.
Qualifications:
- Graduate of high school diploma or equivalent
- At least 2 years experience working in the mental health field, preferred.
- Specific experience in case management and/or utilization review.
- Strong working knowledge of insurance verification, medical necessity requirements for both acute and residential treatment and benefit plans.
- Individual will demonstrate an ability to utilize Microsoft Word, Excel and other hospital specific programs.
- Individual will be detail orientated and have an experience in providing quality customer service.
- Individual will possess a Bachelor s degree in a health related field and/or licensure as an LPN, LBSW, RN, LPC, LMSW, and LCSW.