Utilization Review Specialist

Job Summary

A company is looking for a Utilization Review Specialist in the healthcare field, working remotely.

Key Responsibilities

• Perform pre-certifications and conduct concurrent reviews
• Report discharges and communicate with clients to coordinate billing census
• Work on vital projects within time-sensitive deadlines

Required Qualifications

• Bachelor's degree or 4 years of experience in Utilization Review
• Familiarity with ASAM criteria, substance abuse treatment, and HIPAA guidelines
• Experience in Utilization Review within the behavioral healthcare field
• EMR experience with the ability to enter detailed notes in the system
• Ability to work with insurance companies to gain approval for services