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Acadia
Overview
The role involves monitoring patient service utilization to optimize facility reimbursement and acting as a liaison between managed care organizations and clinical staff. Key duties include conducting medical necessity reviews, managing the appeal process for denied stays, and providing staff training on documentation requirements.
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Compensation
Salary not listed
Posted
12 days ago
Concierge Home Care
Review home health clinical documentation and OASIS audits to ensure accuracy, compliance, and reimbursement integrity. Collaborate with clinical managers and field clinicians to support quality assurance and regulatory initiatives.
$70,000 - $75,000 / YEAR
17 days ago
Village Behavioral Health
The specialist monitors service utilization to optimize facility reimbursement and acts as a liaison between managed care organizations and clinical staff. Key duties include conducting medical necessity reviews, managing the appeal process for denied stays, and providing staff training on documentation requirements.
18 days ago
Wilmington Treatment Center
The role involves monitoring patient service utilization and acting as a liaison between managed care organizations and clinical staff to optimize reimbursement. Key duties include conducting medical necessity reviews, managing the appeal process for denied stays, and providing staff training on documentation requirements.
22 days ago
The specialist monitors patient service utilization to optimize facility reimbursement and acts as a liaison between managed care organizations and clinical staff. They are responsible for conducting medical necessity reviews, managing the appeal process for denied stays, and providing staff training on documentation requirements.
23 days ago
The Utilization Specialist will monitor service utilization for patients to optimize reimbursement and act as a liaison between managed care organizations and clinical staff. They will conduct reviews, gather statistical information, and facilitate peer review calls.
24 days ago
The Utilization Specialist monitors patient service utilization to optimize facility reimbursement and acts as a liaison between managed care organizations and clinical staff. Key duties include conducting medical necessity reviews, managing the appeal process for denied stays, and providing staff training on documentation requirements.
25 days ago
Greenleaf Behavioral Health Hospital
26 days ago
Park Royal Hospital
The specialist monitors patient service utilization to optimize facility reimbursement and acts as a liaison between managed care organizations and clinical staff. Key duties include conducting medical necessity reviews, managing the appeal process for denied stays, and providing staff training on documentation requirements.
The specialist monitors the utilization of services to optimize facility reimbursement and acts as a liaison between managed care organizations and clinical staff. Key duties include conducting medical necessity reviews, managing the appeal process for denied stays, and providing staff training on documentation requirements.
$31 - $50 / HOUR
29 days ago
Conway Behavioral Health
1 month ago
Millcreek of Magee
The Utilization Specialist monitors patient service utilization to optimize facility reimbursement and acts as a liaison between managed care organizations and clinical staff. They are responsible for conducting medical necessity reviews, managing the appeal process for denied stays, and providing staff training on documentation requirements.
Pacific Grove
Acts as a liaison between managed care organizations and clinical staff to coordinate reimbursement and medical necessity reviews. Monitors patient length of stay and manages the formal appeal process for denied admissions or continued stays.
$28 - $34 / HOUR
