Utilization Review Coordinator Full Time 35 hr Weekly

At Root Center, we believe our employees are our greatest asset, and we're committed to creating a supportive and engaging work environment where everyone can thrive. We're driven by a clear purpose and a set of core values that shape everything we do, from nurturing growth and promoting well-being to cultivating connections and making a positive impact.

In fact, 97% of our newly hired employees would recommend us to their friends for employment opportunities, and 96% said they strengthened their skills in their first few months. If you share our commitment to these values and want to join a team that lives them every day, Root Center might be the perfect fit for you!

Starting Hourly Rate - $22.00-$35.00

• Essential Functions
• Utilize information obtained from various resources to ensure that each patient meets the clinical need for admission and ongoing treatment.
• Obtains initial and ongoing concurrent authorizations and assists with discharges in a timely manner. Maintains adequate clinical and billing correspondence and documentation related to authorizations and patient records. Tracks and validates authorizations and new enrollments.
• Collaborates with other departments to identify and document all barriers to access and timely interventions.
• Identifies potential problems regarding payment eligibility for clinical services and recommends corrective action.
• Collaborates with appropriate individuals and departments/clinics to ensure appropriate reimbursement.
• Attend team meetings that foster interdepartmental collaboration with the patient and their family as deemed necessary. Provides input in such meetings regarding utilization management and discharge planning.
• Facilitates communication within the clinic teams and billing to address any issues related to payment/ reimbursement for treatment, admissions and discharges to various programs.
• Assist with scheduling treatments and other administrative tasks.

Minimum Qualification Requirements

• Associates degree required, Bachelor’s degree in Counseling, Human Services or related field preferred.
• A minimum of 2 year experience in behavioral health, medical billing or a related area.
• Experiential or actual knowledge of Medication Assisted Treatment (MAT).
• Knowledge of criteria for Medicare, Medicaid, HMO and private insurance coverage strongly preferred.