Delray Beach, Florida, United States · Remote OK
$60k–$62k/yr
Title: Utilization Review Specialist/Behavioral Health Substance Abuse (Remote) Reports to: UR Manager FLSA Classification: Exempt Full-Time or Part-Time: Full-Time Salary Range: $60,000 to $62,000 Starting pay varies ba…
Skills: Utilization Review, Case Management, Insurance Authorization, ASAM Guidelines, Medical Terminology
Delray Beach, Florida, United States • Remote OK
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The specialist manages the authorization of treatment via insurance and managed care companies by providing medical necessity documentation. They perform pre-certification, concurrent, and appeal reviews while acting as a liaison between the agency and third-party payers.
Requires a BA in Psychology or a related field and 3-5 years of experience in Case Management or Utilization Review. Mandatory experience in a Substance Abuse environment and knowledge of ASAM guidelines are required.
Title: Utilization Review Specialist/Behavioral Health Substance Abuse (Remote)
Reports to: UR Manager
FLSA Classification: Exempt
Full-Time or Part-Time: Full-Time
Salary Range: $60,000 to $62,000
Starting pay varies based on location and experience, in compliance with specific state wage regulations. Competitive rates tailored to your geography and expertise.
Position Overview:
The Utilization Review Specialist is responsible for all aspects of the authorization of treatment via insurance and managed care companies. The role involves providing appropriate client information to third-party payers regarding the medical necessity of treatment in a timely manner. The Utilization Review Specialist will also perform pre-certification reviews, concurrent reviews, and appeal reviews as needed.
Key Responsibilities:
Qualifications:
Minimum Education/Certifications/OTJ Experience:
Knowledge of Subject Matter:
Skills:
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Additional Information:
This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities, and working conditions may change as needs evolve.
Coronis Health is committed to creating a diverse and inclusive environment where all employees are treated fairly and with respect. We are an equal-opportunity employer, providing equal opportunities to all applicants and employees regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or any other protected characteristic. We welcome and encourage applications from candidates of all backgrounds.
RCM solutions freeing healthcare providers from billing burdens while delivering scalable solutions for optimal revenue.
At Coronis Health, we are specialists serving specialists. We simplify the complexities of RCM, empowering providers to focus on delivering exceptional patient care while achieving their financial and operational goals. Whether optimizing the billing process, managing claims or delivering actionable insights, we craft solutions designed to support growth and scalability tailored to each practice's unique needs. With a steadfast commitment to advancing technology, security and innovation, Coronis Health is trusted by thousands of healthcare organizations nationwide to manage their medical billing and revenue cycle operations. Our approach is rooted in empathy, integrity and a relentless passion for driving financial health, operational excellence and strategic success for our clients.
Offices: 255 W Michigan Ave, Jackson, Michigan 49201, US
RCM solutions freeing healthcare providers from billing burdens while delivering scalable solutions for optimal revenue.
At Coronis Health, we are specialists serving specialists. We simplify the complexities of RCM, empowering providers to focus on delivering exceptional patient care while achieving their financial and operational goals. Whether optimizing the billing process, managing claims or delivering actionable insights, we craft solutions designed to support growth and scalability tailored to each practice's unique needs. With a steadfast commitment to advancing technology, security and innovation, Coronis Health is trusted by thousands of healthcare organizations nationwide to manage their medical billing and revenue cycle operations. Our approach is rooted in empathy, integrity and a relentless passion for driving financial health, operational excellence and strategic success for our clients.
Offices: 255 W Michigan Ave, Jackson, Michigan 49201, US
