UR Specialist

Description

Position Summary:

A Utilization Review Specialist’s responsibilities include but are not limited to completing all medical necessity reviews with payer on the facility’s behalf and documenting outcomes in the facility’s EMR (Alleva/KIPU), While communicating to our own team at CRS internally in Monday. In addition, the best candidate for this position will be experienced in behavioral health commercial payer medical necessity criteria. A Utilization Review Specialist will follow the company's process for requesting authorization from insurance providers. A Utilization Review Specialist will also be responsible for following up on all pending/outstanding dates of service with no authorization.

Requirements

Minimum Requirements:

• High School Diploma
• Excellent time management skills
• Strong written/verbal communication
• Conflict resolution skills
• Willingness to investigate and do research
• Strong focus on detail and accurate oral/written reporting
• Open-mindedness to training and feedback

Preferred Requirements:

• Previous experience in the behavioral health/medical field
• Computer literacy and ability to learn new systems

Benefits Include:

• Medical, Dental, Vision, Life
• Employee Assistance Program
• 401k Match
• Paid-Time Off
• Sick Time
• Holiday Pay