Are you the person who loves solving puzzles, spotting details others miss, and keeping everything organized? Do you enjoy working behind the scenes to help patients receive the right care at the right time? If so, we have the perfect opportunity for you! We're looking for a Utilization Review Specialist to join our growing team. No nursing license required! This is a fantastic opportunity for healthcare professionals with experience in insurance verification, medical records, authorizations, claims, case coordination, or healthcare administration. Key Responsibilities Extensive experience in insurance eligibility and benefits Maintain accurate patient and payer records Submit 24-hour notification into LA County TAR Unit Database Complete and submit TAR forms accurately Print or upload patient medical records as required Track submissions to ensure Timely processing and Approval or denial status updates TAR Tracking & Compliance Monitor deadlines and ensure compliance with all timelines Manage denials by tracking appeal deadlines, preparing, and submitting appeal TARs Maintain tracking logs for all initial and appeal TARs While primarily assigned to the inpatient unit, may be required to support the Structured Outpatient Services Program (IOP/PHP) based on census fluctuations and departmental needs Minimum Qualifications High School Diploma or GED required ICD-10 Coding Knowledge or Certification Billing and Coding Knowledge or Certification Medical Records Knowledge or Certification Ability to interact and communicate verbally and in writing with seriously and persistently mentally ill Patients, other staff members, and the public. Ability to speak, read, and write legibly in English. Minimum of two (2) years of experience in behavioral health, healthcare, or hospital settings. Strong teamwork and collaboration skills across disciplines and departments. Proficiency in the use of computers and standard keyboard functions for data entry and electronic documentation. Experience using Electronic Health Records (EHR) systems for documentation and coordination of care.

Pay:

$26.00 - $28.00 per hour

Benefits:

401(k) Dental insurance Retirement plan

Work Location:

In person