Butler , PA 16001
Posted 3 days ago
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Silvermist is looking for a UR Counselor to join our dynamic team. We pride ourselves on offering highly individualized treatment to meet each clients needs. At the heart of our 20-bed program is a team of licensed and experienced clinical professionals who offer each resident at Silvermist a unique, person-focused plan for recovery.
Responsibilities: Conduct admission, continued stay and discharge reviews on all managed care clients. Maintain positive relationships with referral sources and insurance companies. Attend clinical staffing to obtain information for client reviews. Maintain daily UR database accurately. Maintain current insurance eligibility information through EVS, Navinet, etc. Monitor census for accuracy of funding. Perform Act 106 reviews and follow up appeals. Track all county referrals for documentation of admission calls. Maintain and participate in chart reviews to ensure proper paperwork is in place. Work directly with the Billing department to reduce uncovered days of funding. Investigate cases with insurance and referral sources to recuperate lost days of funding. Report to the Program Director on a monthly basis via the UR report. Other duties as deemed necessaryProvide the company with accurate information to ensure full financial coverage for each client day. Provide the referral source(s) with timely information to ensure good customer focus. Maintain client confidentiality and provide a safe therapeutic treatment. Will Provide Direct Care to clients.
- Bachelors' Degree in Counseling, Psychology, or other related Behavioral Health field required. Master's Degree in Behavioral Health is preferred.
- Intermediate knowledge of computer skills and the internet, Microsoft Office experience, Excel- Intermediate level, Word- Intermediate level.
- 1-2 years experience in Utilization Review or Substance Use Disorder Counseling or related position in a similar healthcare setting.
- Knowledge of local, state and federal regulations.
- Knowledge of medical terminology, appeal and denial process, composition of medical records.
- Knowledge of pre-certification process and PCPC. Possesses excellent verbal and written communication skills.
- Knowledge of CARF standards, release of information and confidentiality.
- Knowledge of DSM IV, private care managers and county referral sources.
Medical, Vision, Dental, Life
Paid Days Off