Illinois Licensed Utilization Reviewer

Job Summary

A company is looking for a Utilization Reviewer PRN-Behavioral Health Services.

Key Responsibilities

• Conducts utilization review calls, including precertification and discharge reviews
• Collaborates with clinical staff and physicians to advocate for patients with insurance and managed care companies
• Communicates insurance information and assists with 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 a BSN with RN License
• Preferred: BSN with RN License and relevant certifications
• Behavioral Health experience is preferred