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BRADFORD HEALTH SERVICES
Warrior, AL | Full Time
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Utilization Review Coordinator
$74k-92k (estimate)
Full Time | Ambulatory Healthcare Services 2 Months Ago
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BRADFORD HEALTH SERVICES is Hiring an Utilization Review Coordinator Near Warrior, AL

Position Title: Utilization Review Coordinator
Department: Administrative
Reports To: Executive / Program Director
Supervises: NAEntry Level QualificationsA current RN, LPC, LMFT, LMSW, or LCSW license preferred. Two years minimum experience in utilization review preferred. Must possess good grammatical and communication skills. Must be skilled in Microsoft Office applications and have a working knowledge of office equipment.
  • Must be able to read and comprehend hand-written, printed, and on-line treatment notes and plans.
  • Must be able to hear and comprehend conversations and instructions.
  • Must be able to continuously sit for approximately 7 hrs. per 8 hr. shift.
  • Must be able to walk within the facility a total of approximately two (2) hrs. per day.
  • If recovering, two years of continuous verifiable abstinence.
General ResponsibilitiesComplete coordination of the facilities insurance certification including precertification and continued stay reviews, as well as follow up on all insurance denials, appeals and reconsiderations.
Know and abide by the general provisions of 42 CFR Part 2, “Confidentiality of Drug and Alcohol Abuse Patient Records”, and 45 CFR “Health Insurance Portability and Accountability Act.” This position has unrestricted access to patient identifying and patient health information.
Essential Functions
  • Perform all pre admission certification reviews, continued stay reviews, appeals, denials and/or reconsiderations and provide
information to the appropriate review agency or insurance company.
  • Maintain an "UR Activity Log" which records every review for the facility with financial classification and U.R. information/activity.
  • Maintain a "call back' calendar for continued stay reviews and maintain a U.R. file for each patient.
  • Document, in the patient electronic record software, the review with the managed care organization, including the level of care
requested, the status of the request, outcome and information about the next review.
  • Review and maintain all correspondence pertaining to certification, appeals, denials or reconsiderations, and ensure they are
scanned into the patient electronic health record.
  • Complete all Quality Improvement indicators for Utilization Management, data analysis and reporting.
  • Educate counseling staff regarding data needed to adequately document patient care and educate crisis staff regarding data
needed to adequately document intake assessments and managed care criteria.
  • Ability to work in a constant state of alertness as to perform the job safely.
  • Ability to work in cooperative manner with co-workers, managers, clients and prospective managers.
  • Regular attendance.
  • Any other duties as assigned by supervisor.

Job Summary

JOB TYPE

Full Time

INDUSTRY

Ambulatory Healthcare Services

SALARY

$74k-92k (estimate)

POST DATE

04/04/2024

EXPIRATION DATE

06/14/2024

WEBSITE

bradfordhealth.com

HEADQUARTERS

NASHVILLE, TN

SIZE

500 - 1,000

FOUNDED

1977

TYPE

Private

CEO

CONNIE WOODS

REVENUE

$10M - $50M

INDUSTRY

Ambulatory Healthcare Services

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About BRADFORD HEALTH SERVICES

Bradford is a healthcare organization that offers evidence-based drug and alcohol rehabilitation services for patients.

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