What are the responsibilities and job description for the Utilization Review Specialist position at Burkwood Treatment Center?
Burkwood Treatment Center is seeking a Utilization Review Specialist who is responsible for monitoring utilization of services for patients to optimize reimbursement for the facility from Insurance providers.
Essential Job Functions
Essential Job Functions
- Act as liaison between Insurance providers and the facility professional clinical staff.
- Conduct reviews, in accordance with certification requirements, of insurance plans or other managed care organizations.
- Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services.
- Facilitate peer review calls between facility and external organizations.
- Initiate and complete the formal appeal process for denied admissions or continued stay.
- Provide case management and care coordination services for clients/patients/residents in the facility.
- Bachelor’s degree in Social Work, Counseling or related human service field required.
- One or more years’ experience working in a behavioral health setting preferred.
- Previous experience with the substance abuse population preferred.
- Previous experience in case management and/or utilization review preferred.
- Medical, Dental, Vison insurance.
- Acadia Healthcare 401(k) plan & match.
- Paid vacation and sick time.
- Employee Assistance Program
- Employee Disaster Relief
- Opportunity for growth that is second to none in the industry.
