Position: Utilization Review/Intake Clinician
Together with our billing company you will insure authorization and collection from insurance companies. You will be working closely together with our clinical team to ensure we obtain authorization for treatment for our clients. You will be responsible for In network contracts and relationships with insurance companies. The position does not include any direct clinical work but you will be presenting treatment plans and progress to insurance representatives.
Flexible work hours with option to work some days from home.
Licensed clinician minimum 2 years’ experience with adolescent mental health/co-occurring disorders population.
Reports to: Executive Director, Program Director
Salary: full time position with benefits, 50-80K a year with bonus options.
UTILIZATION REVIEWER JOB DUTIES AND RESPONSIBILITIES:
- Prepares appeal documentation to submit for internal appeals and independent medical reviews from regulatory departments (e.g. DMHC, DOI, etc.)
- Participates in multi-disciplinary treatment planning and updates for all clients (helps ensure clear documentation of all treatment modalities/disciplines)
- Reviews all relevant clinical updates including psychiatric consultations/med changes, adjustments to treatment plan, client participation and progress for concurrent reviews
- Submits all dates of service for services rendered on a weekly basis and reconciles information payments/collection team
- Tracks billing reports, insurance payments for services rendered, and collections for outstanding payments in partnership with our billing company.
- Tracking treatment authorizations and maintaining appropriate documentation
- Facilitates in Quality Improvement Activities and clinical documentation training.
- Obtain policy information for the purpose of gathering IOP/OP benefit information via billing agency