UR Counselor

Pyramid Healthcare Butler , PA 16001

Posted 3 days ago

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 necessary
  • Provide 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.
  • Requirements

    • 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.

    Benefits

    Medical, Vision, Dental, Life

    401K

    Paid Days Off

    Tuition Reimbursement

    And more!

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