Responsibilities

Lighthouse Care Center of Augusta (LCCA) is a multi-discipline behavioral healthcare center that offers mental health services to the communities of surrounding Augusta, Georgia. The Lighthouse Care Center of Augusta is an acute and residential treatment facility providing balanced, top-notch clinical care to children, adolescents and young adults. We provide a carefully-structured and supportive environment, and our education program is accredited through the Georgia Accrediting Commission.

Much more available online at: https://lighthousecarecenters.com/

LCCA is recruiting a sensational Utilization Review Coordinator to join an awesome finance team. RNs encouraged to apply. The Utilization Review Coordinator is responsible for

• reviewing clinical content of medical record and conducting clinical review of data to determine eligibility respective to pre-certification
• participate in treatment team meetings and coordinate with the treatment team on any follow-ups necessary
• reviewing treatment plans and status of approvals from insurers
• coordinates all utilization functions, monitoring the utilization and continuum of services to optimize reimbursement
• collaborate with physicians, therapist, nurses and pertinent staff on gathering the necessary data to communicate with insurance companies/authorizing entities to ensure initial precertification and continued authorization is achieved
• ensure input of pre-certifications and continued stay reviews into Midas
• follow-up on unfinished pre-certifications from the day before
• verify insurance coverage at the first of the month, and post patient payments into MS4
• gathering clinical criteria, communication of clinical criteria, and entry of supporting clinical criteria into computer based systems

This opportunity provides the following:

UHS is Challenging and rewarding work environmentGrowth and development opportunities within UHS and its subsidiariesCompetitive CompensationExcellent Medical, Dental, Vision and Prescription Drug Plan401k plan with company matchGenerous Paid Time Off

Qualifications

POSITION REQUIREMENTS/QUALIFICATIONS:

Total education, experience and Licenses or Certifications:

Masters level education in social science field; 2 years of experience in a psychiatric health care setting in utilization review. Must be license-eligible. Registered Nurses (RN) encouraged to apply.

ENVIRONMENTAL CONDITIONS:

Activities occur inside and outside. The worker is subject to potential hazards such as volatile patients, exposure to heat outdoors, etc.

PHYSICAL REQURIEMENTS:

Physical demands require daily walking, standing, kneeling, balancing, climbing, and etc. The following applies if the incumbent directly conducts adventure-type programs such as the ROPES course. Visual Acuity – mobile equipment operators: This is a minimum standard for use with those who operate cars, trucks, forklifts, cranes, and high equipment.

Machines, Tools and Equipment used on job:

Personal computer/internet, Fax machine/copy machine

DEGREE OF SUPERVISION:

Minimum. Must be able to work independently, but also take directions