Utilization Review Coordinator

Mount Yonah Medical Billing
Utilization Review Coordinator
Job Description:
The Utilization Review Coordinator is a vital member of the MYMB Care component of the System of Care.  The Utilization Review Coordinator is responsible for analyzing patient records to determine legitimacy of admission, treatment, and length of stay in health-care facility to comply with government and insurance company reimbursement policies.
Type: Full time
Pay Rate: $18/HR
Schedule: Monday – Friday; 8:30am – 5pm
Education:

• High School Diploma/GED – BS degree preferred.
• Current (five-years) of no felonies or substance abuse convictions.

Experience:

• Must have two-years of continuous sobriety prior to hire, if a recovering alcoholic or drug addict and participate in a self-help program.
• 1 year of collections experience in the healthcare field preferred; preferably in the mental health and substance abuse field.
• Knowledge of insurance submittals procedures and medical forms and coding. 

Knowledge And Training Required at Time of Hire:

• Strong problem solving, follow through, and analytical skills required.
• Excellent English; verbal and written communication skills required.
• Ability to work independently and to adapt to a fast changing environment.
• Proficiency in Microsoft Office including Excel, Word and other medical collections software.
• Must have attention to detail with an eye for accuracy.
• Creative, self-disciplined and capable of identifying and completing critical tasks independently and with a sense of urgency required.
• Must be able to speak clearly and concisely over the telephone.

Responsibilities:

• Reviews patient records to track patient progress through treatment.
• Performs continual review on patient medical records
• Provides initial and concurrent reviews with insurance companies to certify client treatment.
• Identifies active benefits
• Follows up on a daily basis for insurance verification
• ID ASAM criteria
• Consults with Clinical team on appropriateness of length of stay. 
• Develops good working relationships with insurance companies.
• Review and monitor assigned accounts.  
• Provide timely follow-up on payment arrangements.
• Fax documents to client accounts for effective follow up.
• Performs other duties assigned.

Why You Should Join Our Team:

• Paid training
• Health insurance offered after 90 days
• Accrued PTO offered after 90 days
• Dental, vision, life insurance offered after 90 days
• Opportunity to grow into a leadership role

Bonus structure after 90 days

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