Note: The job is a remote job and is open to candidates in USA. Compass Health Center is a recognized leader in crisis-level mental health, providing patient-centered care in the Behavioral Health space. The Utilization Review Specialist will obtain insurance authorization for patients, act as a liaison between the clinical team and insurance companies, and advocate for patients to overcome financial barriers to treatment.
Responsibilities
- Contacting Insurance companies to verify insurance coverage and obtaining approval of treatment as recommended by the clinical team
- Collaborating with the clinical team to compile treatment plans and supporting clinical documentation
- Working with all internal departments as necessary, such as Revenue Cycle and Patient Advocates
- Accurately documenting Electronic Medical Records to reflect approval or denial of treatment authorization
- Communicating insurance authorizations/denials and insurance needs to appropriate internal staff
- Scheduling and delivering concurrent authorization reviews as required by individual insurance companies
- Coordinating physicians’ reviews and appeals
Skills
- Previous healthcare or insurance experience
- Knowledge of medical terminology and psychiatric criteria
- Have the ability to analyze and communicate clinical information from progress, group and psychiatric chart notes
- Have the ability to work autonomously and independently while working collaboratively as part of a team
- Have the ability to think critically and make decisions within individual role and responsibility
- Possess strong written and verbal skills
- Have strong organizational and time management skills with ability to manage workload independently
- Have the ability to foster and maintain positive relationships externally and internally
- Bachelor's Degree (preferred) or relevant experience
- Familiarity with Microsoft Office, Outlook, and EMR
Benefits
- Comprehensive medical/dental/vision plans
- 401k program with company matching
- Generous PTO (including competitive parental leave after 1 year of employment)
- Continuous training through CEU seminars and volunteering opportunities
Company Overview
Compass Health Center is the expert in crisis level mental health care for children, adolescents, young adults, and adults. It was founded in 2011, and is headquartered in Chicago, Illinois, USA, with a workforce of 501-1000 employees. Its website is https://compasshealthcenter.net.
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