Location
Peachtree City, Georgia
The UR Associate will secure insurance authorization for SUD/MH treatment by communicating with insurance companies, becoming familiar with ASAM and LOCUS criteria, and ensuring strong documentation. Responsibilities also include evaluating treatment outcomes, analyzing data for compliance, and attending weekly meetings with assigned facilities.
Candidates must possess a High School Diploma, excellent time management, strong communication, and conflict resolution skills. The role requires strong documentation abilities, a willingness to conduct research, attention to detail, and computer literacy, with previous behavioral health or medical field experience being preferred.
The UR Associate role presents an exciting opportunity to start your path in advocating for client care in behavioral health facilities. This is the right position for you if you are passionate about helping those with MH/SUD and want to procure coverage for them. This role will bestow an opportunity to develop your interests in behavioral health, ensure client’s seeking help have coverage as long as needed, and learn medical necessity through ASAM and LOCUS criteria. You will ensure clients are getting MH/SUD treatment covered by insurance, build rapport with sites we service, communicate what is needed to secure authorization to clinical teams, develop conflict resolution, and build skills through research. This position comes with further career development as well as interesting and satisfying professional challenges.
Communicate with insurance companies to secure authorization for SUD/MH treatment. Become familiar with ASAM and LOCUS criteria. Strong and clear documentation when corresponding with insurance companies. Become accustomed to scheduling and completing peer reviews when able. Become familiar with insurance hold times, the types of submissions they require for authorization, and prioritize cases based on level of care/last covered day. Evaluate treatment outcomes and make recommendations for adjustments as needed based on medical necessity. Analyze data and documentation to ensure compliance with healthcare policies and regulations. Attend weekly meetings with assigned facilities to discuss status and medical necessity of cases. Abide by documentation guidelines and document EMRs and Monday clearly.
Job Skills & Qualifications High School Diploma Excellent time management skills Strong communication and conflict resolution skills Willingness to investigate and do research Strong documentation and written communication skills Strong focus on detail and accurate oral and written reporting Computer literacy and ability to learn new systems Previous experience in the behavioral health/medical field, preferred. Benefits Include: Medical, Dental, Vision, Life Employee Assistance Program 401k Match Paid-Time Off Sick Time Holiday Pay
