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Assistant Remote Utilization Review Jobs in Tennessee

Solid Rock Recruiting LLC

Remote Tax Manager

Nashville, TN · On-site +1

$135K - $195K/yr

Prepare and review: * Individual (1040), business (1120S, 1065), and basic corporate returns ... * Assist with year-end planning and projections * Ensure compliance with federal and state tax ...

Wing Assistant

$40K - $50K/yr

At Wing, we give growing businesses access to the top tier of global remote talent supercharged by ... These tools assist our recruitment team but do not replace human judgment. Final hiring decisions ...

Lift Business Resources

Executive Assistant

Nashville, TN · On-site +1

$23/hr

Fully Remote | 30 Hours per Week | $23.00 per Hour | PTO Available Location Requirements Lift ... Gather, review, and synthesize information from multiple platforms, including Salesforce, Microsoft ...

TeleMate Health

Physician Assistant (PA-C)

Old Hickory, TN · Remote

$100K - $135K/yr

Physician Assistant (PA) - Chronic Care Management & Remote Patient Monitoring Position Summary ... Review of medical history and diagnoses * Medication reconciliation and review * Assessment of ...

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Assistant Remote Utilization Review information

What is the difference between Assistant Remote Utilization Review vs Utilization Review Nurse?

AspectAssistant Remote Utilization ReviewUtilization Review Nurse
CredentialsTypically requires a nursing license, certification in case management or utilization reviewRegistered Nurse (RN) license, often with additional certifications in case management or utilization review
Work EnvironmentRemote, administrative setting, telehealth or telecommutingRemote or hospital/clinic settings, primarily telehealth or administrative
Employer & IndustryHealth insurance companies, managed care organizations, healthcare providersHospitals, insurance companies, healthcare organizations

Both roles involve reviewing patient cases to determine appropriate care and resource utilization. The Assistant Remote Utilization Review typically supports the process with administrative tasks and basic review, while the Utilization Review Nurse performs more in-depth clinical assessments. Both require nursing credentials and often work remotely within healthcare or insurance industries.

What are the most commonly searched types of Remote Utilization Review jobs in Tennessee? The most popular types of Remote Utilization Review jobs in Tennessee are:
What are popular job titles related to Assistant Remote Utilization Review jobs in Tennessee? For Assistant Remote Utilization Review jobs in Tennessee, the most frequently searched job titles are:
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Assistant Remote Utilization Review jobs near you
Admissions Services Specialist Acute

Admissions Services Specialist Acute

Acadia Healthcare

Franklin, TN • Remote

$18 - $24.75/hr

Full-time

Re-posted 12 days ago

Acadia Healthcare rating

6.2

Company rating: 6.2 out of 10

Based on 189 frontline employees who took The Breakroom Quiz

699th of 886 rated healthcare providers

Job description

Admissions Services Specialist

Location: Remote

Acadia Healthcare is seeking remote Admissions Services Specialists to support our Acute Behavioral Health Facilities from coast to coast.

Our Mission

Acadia Healthcare’s purpose is to Lead Care With Light and our mission is to be a world-class organization that sets the standard for excellence in the treatment of mental health and addiction concerns. We strive to maintain our standing as a thought leader in the behavioral healthcare industry, providing treatment that is synonymous with compassion and innovation.

Highlights of this role include:

  • Ability to verify benefits information for assigned facility
  • 1 weekend day shift Friday, Saturday, Sunday
  • Experience monitoring and processing patient referrals (may include fax referrals)
  • Respond to inquiries about facilities within policy timeframes
  • Support Acadia Healthcare admissions departments throughout the country

As one of the nation's leaders in treating individuals with acute co-occurring mood, addiction, and trauma, Acadia Healthcare places a strong emphasis on our admissions & intake functions to allow us to help every possible person in need.


This person will be supporting Acadia Acute Admissions departments around the country in a remote capacity.


Essential Functions

  • Manage Referral Management Portals
  • Monitor all faxed referrals
  • Monitor all webforms and call center handoffs/rollover referrals
  • Utilize facility admissions/exclusionary criteria to process incoming types of referrals
  • Respond to inquiries about the facility within facility policy timeframes.
  • Document calls inside of Salesforce and follow-up as needed
  • Complete Prior Authorization
  • Pre-Admit the patients in billing system
  • Coordinate with local admissions department regarding bed availability
  • Facilitate intake, admissions, and utilization review process for incoming patients.
  • Perform insurance benefit verifications, disseminating the information to appropriate internal staff
  • Collaborate with other facility medical and psychiatric personnel to ensure appropriate recommendations for referrals
  • Coordinate admission and transfer between levels of care within the facility
  • Communicate projected admissions to designated internal representative in a timely manner
  • Ensure all medical admission documentation is gathered from external sources prior to patient admission and secure initial pre-authorization for treatment and admission
  • Complies with organizational policies, procedures, performance improvement initiatives and maintains organizational and industry policies regarding confidentiality
  • Communicate clearly and effectively to person(s) receiving services and their family members, guests and other members of the health care team

Education/Experience/Skill Requirements

  • Bachelor’s or Master’s degree in Behavioral Science, Social Work, Sociology, Nursing, or a related field; in some states, RN, LVN/LPN
  • Knowledge of admission/referral processes, techniques, and tools
  • Familiarity with behavioral health issues and services
  • Solid understanding of financial principles and insurance reimbursement practices
  • Knowledge and proficiency with Salesforce.com (or other CRM application), Concur, and MS Office application.

 

Licenses/Designations/Certifications

  • Licensure, as required for the area of clinical specialty, i.e., RN license, CAC or other clinical counseling or therapy license, as designated by the state in which the facility operates.

 

Supervisory Requirements

  • This position is an Individual Contributor

We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual’s characteristics protected by applicable state, federal and local laws.

AHCORP

#LI-TB1

What Acadia Healthcare employees say

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About Acadia Healthcare

Sourced by ZipRecruiter

Acadia Healthcare is a leading provider in the healthcare and hospital industry, based in Franklin, Tennessee, United States. The company is recognised for its commitment to creating a behavioural health network that provides accessible, high-quality treatment options for individuals suffering from mental health issues, addiction, eating disorders, and PTSD. Acadia Healthcare was founded in 2005, with the mission to create a world-class organization that sets the standard of excellence in the treatment of specialty behavioural health and addiction disorders.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Franklin, TN, US

Year founded

2005

Social media

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