Utilization Review Specialist (Behavioral Health)

Full-time & Part-time opportunities available!

WHY BRIGHTON?

We are holistic. We are dignity and hope. We are excellence.

Our mission at Brighton Recovery Center is to provide the best holistic care for our patients and their families. As a quickly growing company, we are always looking for passionate, talented, and creative people to join our team. We have dedicated teams, supportive leadership, opportunities for growth, and a lot of fun!

JOB SUMMARY

The Utilization Review Specialist acts as a liaison with a patient’s insurance company, coordinates billing, payments, and authorizations with insurance companies, and monitors authorizations.

QUALIFICATIONS

Required:

• High School Diploma/Equivalent
• Valid Driver’s License
• Proficiency in ASAM 4 criteria
• Proficiency in Microsoft Office Suite, including Word, Excel
• 5 years’ working experience or a minimum of Bachelor’s Degree in Social Work, Psychology, or other related field

Preferred:

• Active SUDC, ASUDC, CSW, LCSW, CMHC, ACMHC, RN, or LPN license.
• 1 year experience working in a residential/behavioral healthcare setting.
• Experience working with insurance companies.
• Current CPR Certification

JOB DUTIES AND RESPONSIBILITIES

• Act as an advocate and liaison with client’s insurance to coordinate authorization for treatment.
• Manage patient authorizations for treatment.
• Coordinate with clients, treatment team members and billing department routinely to ensure timely and necessary communications to obtain authorizations and claims payment from payers.
• Complete initial pre-cert requests with new admits as well as manage ongoing concurrent reviews for continued authorizations from payers.
• Auditing and submitting requested medical records for claims
• Maintain all spreadsheets and data sources to track authorizations and data.
• Maintain organization and filing of all patient financial records.

KNOWLEDGE, SKILLS, AND ABILITIES

• Ability to communicate effectively
• Computer literacy and proficiency in the use of Microsoft Office software
• Knowledge of medical and behavioral health terminology
• Knowledge in reviewing medical and behavioral health records for medical necessity
• Skill in operating a personal computer and utilizing a variety of software applications, printer and fax machine
• Ability to apply UR Guidelines and processes consistently
• Knowledge of the current version of the Diagnostic Statistical Manual of Mental Disorders (DSM)

Pay: From $18.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Referral program
• Vision insurance

People with a criminal record are encouraged to apply

Work Location: Hybrid remote in Midvale, UT 84047