Utilization Review Specialist
New
C
Compass Health CenterBehavioral Health
RemoteFull-TimeMiddle
Salary45,000 - 55,000 USD per year
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Job Details
- Required Skills
- Microsoft Office
Requirements
- Bachelor’s degree preferred or relevant equivalent experience.
- Previous professional experience in healthcare or insurance.
- Knowledge of medical terminology and psychiatric criteria.
- Ability to analyze clinical information from progress, group, and psychiatric chart notes.
- Strong written and verbal communication skills.
- Proficiency with Microsoft Office, Outlook, and EMR software.
- Strong organizational and time management skills to manage workload independently.
- Ability to work autonomously while collaborating effectively within a team.
- Critical thinking and independent decision-making skills.
- Ability to foster and maintain professional relationships.
Responsibilities
- Contact insurance companies to verify coverage and obtain treatment approval.
- Collaborate with the clinical team to compile treatment plans and documentation.
- Coordinate with Revenue Cycle and Patient Advocate departments.
- Document insurance authorization status accurately within Electronic Medical Records.
- Communicate insurance needs, approvals, and denials to internal staff.
- Schedule and conduct concurrent authorization reviews.
- Coordinate physician reviews and appeals.
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