Utilization Review Coordinator

Onward Behavioral Health Duncansville , PA 16635

Posted 3 weeks ago

Hours (40 hours) M-F 8am-4pm or 4pm - 12am (Availability to work in either Ducansville or Allentown PA, whichever works best for you)

Deliverables/Principal Results Expected:

  • Conduct admission, continued stay and discharge reviews on all managed care clients.

  • Maintain positive relationships with referral sources and insurance companies.

  • Track admissions, continued stay and discharge PCPC requirements for county referrals.

  • Maintain organized system of reporting to counselors when PCPC's are due and when review calls are to be made.

  • Monitor census for accuracy of level of care and funding issues.

  • 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.

Requirements

Education, Experience: Associate Degree or equivalent required. Bachelor of Science in Behavioral Health or RN is preferred. Intermediate knowledge of computer skills and the internet, Microsoft Office experience, Excel- Intermediate level, Word- Intermediate level. 3-5 years' experience as a UR Coordinator or related position in a similar healthcare setting.

Job-related Behavioral Characteristics: Knowledge of Confidentiality protocol, team player, excellent communication skills, self starter, ability to act independently, reliable, punctual, good time management skills, excellent at accuracy and organization, thorough, ability to complete assignments on time.

Benefits

  • Life, Dental, Vision and Health Insurance

  • 401k

  • Leadership Opportunities

  • Education Reimbursment

  • Employee Discounts

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Utilization Review Coordinator

Onward Behavioral Health