Utilization Coordinator

Lutheran Social Services of Illinois (LSSI), is a leading not-for-profit organization providing healing, justice and wholeness to people and communities. For over 150 years, LSSI has made a difference in the lives of children and families, and we're still a strong, viable presence in the State of Illinois, continuing that commitment to making a difference.

LSSI is hiring a full-time Utilization Coordinator, Monday through Friday. Responsible for obtaining verification and authorization for substance use clients for residential treatment services. Collaborate with Counseling/treatment staff to write and submit insurance authorization documentation, concurrent reviews, and other activities necessary to obtain insurance authorization. Coordinate insurance appeals process, as needed.

Benefits And Perks

LSSI is growing! Come be a part of this rewarding environment, and enjoy the knowledge that you’re helping make a positive difference in the lives of others, as well as these career advantages: 

• On-Demand Flexible Paydays for earned wages through an app called Dayforce Wallet. 
• Competitive salary based upon relevant education, experience, and licensure. 
• Salary $25-$26.50/Hourly. 
• Opportunity for advancement. 
• Comprehensive benefits package for Full-Time employees includes healthcare insurance, up to 26 days of paid time off per calendar year, 11 paid holidays, sick time, 403(b) plan, Employee Assistance Program, and flexible hours. 
• The paid training you need to learn, grow, and succeed!
  
  

Essential Functions

• Manage authorizations for Residential Programs, including but not limited to submitting required documentation, completing initial and concurrent review in collaboration with treatment staff, and coordinating appeals.
• Run daily and weekly reports to monitor for failed activities and failed claims specifically related to “No authorization” and “No Active Treatment Plan”. Communicate information to program staff and supervisors.
• Coordinate with Front Desk, Billing, Clinical, and Program staff to maintain efficiency in obtaining authorizations.
• Maintain familiarity with LSSI requirements and LSSI funding source requirements as they relate to authorization responsibilities.
• Respond to inquiries from external partners and communicate with external partners regarding authorizations.
• Maintain familiarity with Electronic Health Record and the ensure all documentation is competed in a timely manner and in compliance with the standards for LSSI and other regulatory bodies.
• Ensure adherence to ethical standards of treatment, including NASW Code of Ethics.
• Maintain familiarity with emergency procedures.
• Demonstrate professional, positive behavior and carry out responsibilities with integrity, treating clients, families, other LSSI workforce members, and collaborative organizations and/or individual in a dignified, respectful, honest and fair manner.
  
  

Position Qualifications

• High school diploma or equivalent required.
• Associates, bachelors, or masters degree preferred.
• One (1) to three (3) years experience in substance use field preferred.
• Background check clearance required.
• Annual TB test required.
• Demonstrated proficiency with Electronic Healthcare Record documentation and review required.
• Familiarity with accreditation and licensure standards preferred.
• Demonstrated ability to communicate in a clear, comprehensible manner, both verbally and in writing.
• Excellent organization, presentation and pc/computer skills, including experience using Microsoft Office (Outlook, Teams, Word, Excel, PowerPoint) along with other related software.
  
  

We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, sexual orientation, protected veteran status, pregnancy, any other characteristic protected by law.