Job Summary
A company is looking for a Utilization Reviewer PRN in Behavioral Health Services.
Key Responsibilities
- Conduct utilization review calls, including precertification, continued stay, discharge reviews, and retrospective reviews
- Collaborate with clinical staff and physicians to advocate for patients with insurance and managed care companies
- Communicate insurance information and assist with discharge planning and appeals for unfavorable utilization review decisions
Required Qualifications
- 2+ years of experience in a relevant field
- Master's Degree in Social Work or Psychology or BSN with RN License
- Behavioral Health experience is preferred
- Certifications such as BLS, CADC, CSADC, CPC, LCSW, MSW, or RN are preferred
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