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JOB SUMMARY
The Utilization Review specialist is responsible for managing an active caseload of clients for the following levels of care: Detox, Residential, Intensive Outpatient, and Behavioral Health. S/he acts as a liaison between the Billing Manager, the client, and the Clinical Team. Candidate with at least three (3) years of clinical experience with addiction treatment of adults experiencing substance use problems and disorders. The review specialist is primarily responsible for ensuring that every client at our addiction treatment centers and primary mental health has the appropriate precertification and concurrent reviews completed in a timely manner.
ESSENTIAL DUTIES AND RESPONSIBILITIES
The duties listed below are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or a logical assignment to this class.
ABILITIES
DEPENDABILITY:
Personally responsible; completes work in a timely, consistent manner; works hours necessary to complete assigned work; is regularly present and punctual; arrives prepared for work; is committed to doing the best job possible; keeps commitments.
ATTENDANCE AND PUNCTUALITY:
Is prompt and on time for works, assignments and meetings. Notifies supervisor prior to lateness or absence. Understands that excess absences pose a hardship on other employees.
JOB SKILLS AND KNOWLEDGE:
Employee completes all chart related documents and correspondence for assigned clients in a timely manner.
QUANTITY AND QUALITY OF WORK:
ATTITUDE:
CONFIDENTIALITY:
Always knows and follows applicable laws and regulations, and standard procedures.
COMMUNICATION SKILLS:
Is effective in written and oral expression. Demonstrates proper telephone etiquette and able to communicate easily with clients, referral sources, and visitors in an appropriate manner. Relates to clients and co-workers in a respectful and professional manner.
CONDUCT:
Conducts oneself in a manner consistent with the organization's Core Values and code of conduct. Shows professionalism in the office setting.
FLEXIBILITY / HANDLING EMERGENCIES:
Responds well to changing situations or routines. Handles crisis situations calmly and professionally.
COMPETENCIES:
To perform the job successfully, an individual should demonstrate the following competencies to perform the essential functions of this position.
MINIMUM QUALIFICATIONS:
EDUCATION/EXPERIENCE:
CERTIFICATES & LICENSES:
Has CPR and First Aid certifications.
KNOWLEDGE:
Job Type: Full-time
Pay: $21.00 - $24.00
Work Remotely
Job Type: Full-time
Pay: $24.00 - $28.00 per hour
Benefits:
Schedule:
Application Question(s):
Education:
Experience:
Work Location: Multiple locations
Full Time
$67k-93k (estimate)
01/08/2024
07/30/2024
alterhealth.net
Woodstock, NY
<25
The job skills required for Utilization Review Specialist include Managed Care, Mental Health, Billing, Planning, Utilization Management, Clinical Documentation, etc. Having related job skills and expertise will give you an advantage when applying to be an Utilization Review Specialist. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Utilization Review Specialist. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Utilization Review Specialist positions, which can be used as a reference in future career path planning. As an Utilization Review Specialist, it can be promoted into senior positions as an Utilization Review Manager - Home Care that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Utilization Review Specialist. You can explore the career advancement for an Utilization Review Specialist below and select your interested title to get hiring information.
If you are interested in becoming an Utilization Review Specialist, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become an Utilization Review Specialist for your reference.
Step 1: Understand the job description and responsibilities of an Accountant.
Quotes from people on Utilization Review Specialist job description and responsibilities
Utilization Review Specialists ensure that Doctors and Nurses choose only the best treatments for them.
03/11/2022: Fort Myers, FL
Utilization review typically refers to the review of services that have already been delivered, while utilization management often refers to the review of coverage for future medical services.
02/16/2022: Louisville, KY
Assess plans for patient care and determine what treatment is appropriate and most cost-effective
02/15/2022: Augusta, GA
Analyze electronic medical records, and inform medical staff whether a medical claim is denied,
03/11/2022: Boston, MA
Prepares and submits regular reports on utilization control and on review activities.
02/26/2022: Reading, PA
Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.
Career tips from people on Utilization Review Specialist jobs
Know where to find utilization review jobs.
03/13/2022: Clarksville, TN
Create a utilization review cover letter.
02/18/2022: Reno, NV
Sign up for free credit monitoring.
03/16/2022: New London, CT
Set up documentation shortcuts.
03/05/2022: Lawton, OK
Take the certification examination.
05/08/2022: New Bedford, MA
Step 3: View the best colleges and universities for Utilization Review Specialist.