Prior to expected date of service, prepare and submit precertification and prior authorizations to ... Work with team lead/utilization review supervisor to establish goals and communicate associated ...
New
Prior to expected date of service, prepare and submit precertification and prior authorizations to ... Work with team lead/utilization review supervisor to establish goals and communicate associated ...
New
... you'll contribute Utilization Review Specialist facilitates clinical reviews on all patient ... Reports appropriate denial, and authorization information to designated resource. * Actively ...
... you'll contribute Utilization Review Specialist facilitates clinical reviews on all patient ... Reports appropriate denial, and authorization information to designated resource. * Actively ...
Previous utilization review experience in a psychiatric healthcare facility preferred. * License ... Reports appropriate denial, and authorization information to designated resource. * Actively ...
Previous utilization review experience in a psychiatric healthcare facility preferred. * License ... Reports appropriate denial, and authorization information to designated resource. * Actively ...
... you'll contribute Utilization Review Specialist facilitates clinical reviews on all patient ... Reports appropriate denial, and authorization information to designated resource. * Actively ...
... you'll contribute Utilization Review Specialist facilitates clinical reviews on all patient ... Reports appropriate denial, and authorization information to designated resource. * Actively ...
Previous utilization review experience in a psychiatric healthcare facility preferred. * License ... Reports appropriate denial, and authorization information to designated resource. * Actively ...
Previous utilization review experience in a psychiatric healthcare facility preferred. * License ... Reports appropriate denial, and authorization information to designated resource. * Actively ...
UTILIZATION REVIEW RN
Seymour, IN · On-site
Utilization Review and Medical Necessity * Concurrent Review and Length of Stay Management ... Payer Communication & Authorization * Denials Management and Appeals Equal Opportunity Employer ...
UTILIZATION REVIEW RN
Seymour, IN · On-site
Utilization Review and Medical Necessity * Concurrent Review and Length of Stay Management ... Payer Communication & Authorization * Denials Management and Appeals Equal Opportunity Employer ...
UTILIZATION REVIEW RN
Seymour, IN · On-site
... DUTIES 1. Utilization Review and Medical Necessity 2. Concurrent Review and Length of Stay ... Authorization 5. Denials Management and Appeals Equal Opportunity Employer This employer is ...
UTILIZATION REVIEW RN
Seymour, IN · On-site
... DUTIES 1. Utilization Review and Medical Necessity 2. Concurrent Review and Length of Stay ... Authorization 5. Denials Management and Appeals Equal Opportunity Employer This employer is ...
... you'll contribute Utilization Review Specialist facilitates clinical reviews on all patient ... Reports appropriate denial, and authorization information to designated resource. * Actively ...
... you'll contribute Utilization Review Specialist facilitates clinical reviews on all patient ... Reports appropriate denial, and authorization information to designated resource. * Actively ...
... you'll contribute Utilization Review Specialist facilitates clinical reviews on all patient ... Reports appropriate denial, and authorization information to designated resource. * Actively ...
... you'll contribute Utilization Review Specialist facilitates clinical reviews on all patient ... Reports appropriate denial, and authorization information to designated resource. * Actively ...
... thorough review of the total resources available to patient pre and post-discharge from ... Completes pre-certification and prior authorization timely for admission and or services. Documents ...
Quick apply
... thorough review of the total resources available to patient pre and post-discharge from ... Completes pre-certification and prior authorization timely for admission and or services. Documents ...
... thorough review of the total resources available to patient pre and post-discharge from ... Completes pre-certification and prior authorization timely for admission and or services.
... thorough review of the total resources available to patient pre and post-discharge from ... Completes pre-certification and prior authorization timely for admission and or services.
... thorough review of the total resources available to patient pre and post-discharge from ... Completes pre-certification and prior authorization timely for admission and or services.
... thorough review of the total resources available to patient pre and post-discharge from ... Completes pre-certification and prior authorization timely for admission and or services.
... thorough review of the total resources available to patient pre and post-discharge from ... Completes pre-certification and prior authorization timely for admission and or services.
... thorough review of the total resources available to patient pre and post-discharge from ... Completes pre-certification and prior authorization timely for admission and or services.
Assigned projects span drug coverage administration, Preferred Drug List (PDL) management, prior authorization, utilization management, drug utilization review, clinical criteria configuration, and ...
Assigned projects span drug coverage administration, Preferred Drug List (PDL) management, prior authorization, utilization management, drug utilization review, clinical criteria configuration, and ...
Assigned projects span drug coverage administration, Preferred Drug List (PDL) management, prior authorization, utilization management, drug utilization review, clinical criteria configuration, and ...
Assigned projects span drug coverage administration, Preferred Drug List (PDL) management, prior authorization, utilization management, drug utilization review, clinical criteria configuration, and ...
The Utilization Management Representative I is responsible for coordinating cases for precertification and prior authorization review. Hours : Training is conducted from 7:00 AM to 3:30 PM Mountain ...
The Utilization Management Representative I is responsible for coordinating cases for precertification and prior authorization review. Hours : Training is conducted from 7:00 AM to 3:30 PM Mountain ...
The Utilization Management Representative I is responsible for coordinating cases for precertification and prior authorization review. Hours : Training is conducted from 7:00 AM to 3:30 PM Mountain ...
The Utilization Management Representative I is responsible for coordinating cases for precertification and prior authorization review. Hours : Training is conducted from 7:00 AM to 3:30 PM Mountain ...
The Utilization Management Representative I is responsible for coordinating cases for precertification and prior authorization review. Hours : Training is conducted from 7:00 AM to 3:30 PM Mountain ...
The Utilization Management Representative I is responsible for coordinating cases for precertification and prior authorization review. Hours : Training is conducted from 7:00 AM to 3:30 PM Mountain ...
BCBA
$70K - $86K/yr
Reviews client assessments, treatment plans, behavior plans, and other protocols at a minimum of ... Maintains high authorization utilization of assigned caseload * May provide direct therapy to ...
BCBA
$70K - $86K/yr
Reviews client assessments, treatment plans, behavior plans, and other protocols at a minimum of ... Maintains high authorization utilization of assigned caseload * May provide direct therapy to ...
BCBA
Indianapolis, IN · On-site
$70K - $86K/yr
Reviews client assessments, treatment plans, behavior plans, and other protocols at a minimum of ... Maintains high authorization utilization of assigned caseload * May provide direct therapy to ...
BCBA
Indianapolis, IN · On-site
$70K - $86K/yr
Reviews client assessments, treatment plans, behavior plans, and other protocols at a minimum of ... Maintains high authorization utilization of assigned caseload * May provide direct therapy to ...
Authorization Utilization Review Bcba information
What are the key skills and qualifications needed to thrive as an authorization utilization review BCBA?
To thrive as an Authorization Utilization Review BCBA, you need a strong background in applied behavior analysis, in-depth knowledge of utilization review processes, and active BCBA certification. Familiarity with insurance authorization platforms, electronic health record (EHR) systems, and current procedural terminology (CPT) coding is typically required. Excellent analytical skills, attention to detail, and effective communication abilities set outstanding candidates apart. These skills ensure accurate authorization decisions, regulatory compliance, and efficient collaboration with providers and insurance teams.
What does an authorization utilization review BCBA do?
An Authorization Utilization Review BCBA is primarily responsible for reviewing clinical documentation to determine the medical necessity of ABA services, preparing and submitting authorization requests to insurance companies, and responding to requests for additional information. The role involves collaborating closely with clinical staff, insurance representatives, and sometimes directly with clients or caregivers to ensure all documentation meets regulatory and payer requirements. You may also provide guidance to therapy teams on proper documentation and help streamline internal utilization review processes. This position requires balancing client advocacy with payer guidelines, making each day both detailed and dynamic.
What is an authorization utilization review BCBA?
An Authorization Utilization Review BCBA is responsible for reviewing treatment plans, ensuring medical necessity, and obtaining insurance authorizations for applied behavior analysis (ABA) services. They analyze data, collaborate with clinicians, and communicate with insurance providers to optimize care while adhering to policies and guidelines. Their goal is to ensure that ABA services are both effective and appropriately funded within insurance requirements.
What are popular job titles related to Authorization Utilization Review Bcba jobs in Indiana?
For Authorization Utilization Review Bcba jobs in Indiana, the most frequently searched job titles are:
What job categories do people searching Authorization Utilization Review Bcba jobs in Indiana look for?
The top searched job categories for Authorization Utilization Review Bcba jobs in Indiana are:
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Cities in Indiana with the most Authorization Utilization Review Bcba job openings:
Full-time
This job post has expired today. Applications are no longer accepted.
Job description
About IHTC
At the Innovative Hematology (IHI), we offer a future where people with rare blood disorders flourish. Our experts provide the highest quality comprehensive services and holistic care to patients with bleeding, clotting and other hematologic disorders, and to their families.
What You Will Do
As the Utilization Review Specialist, you will be responsible for verifying patient eligibility with payers and works in conjunction with the pharmacy staff and providers to coordinate referrals, precertification, or prior authorizations for medications.
The Opportunity
Knowledge:
Skills:
Abilities:
Requirements
Benefits
IHI is a not-for-profit program based in Indianapolis and offers a competitive salary and benefit package.
IHI is the only ederally designated comprehensive hemophilia program in Indiana, and serves the entire state through services available in Indianapolis and at outreach clinics.
IHI is a leader in hemophilia care, education and clinical research and has a dedicated on-site multidisciplinary staff to ensure availability of a wide range of required services.
IHI participates in national and international clinical research, including new infusion products and therapies, investigation of long-term outcomes, and the impact of associated conditions. The IHTC research program provides patients access to new therapies, and an opportunity to improve care. Our center has more than 70 clinical research projects involving bleeding disorders, sickle cell disease, thrombosis and more.
The Indiana Hemophilia and Thrombosis Center is an Equal Opportunity Employer.
At the Innovative Hematology (IHI), we offer a future where people with rare blood disorders flourish. Our experts provide the highest quality comprehensive services and holistic care to patients with bleeding, clotting and other hematologic disorders, and to their families.
What You Will Do
As the Utilization Review Specialist, you will be responsible for verifying patient eligibility with payers and works in conjunction with the pharmacy staff and providers to coordinate referrals, precertification, or prior authorizations for medications.
The Opportunity
- Secure appropriate medical documentation requested by third-party insurance providers.
- Verify insurance coverage for pharmacy benefits.
- Prior to expected date of service, prepare and submit precertification and prior authorizations to payers. Follow up with patients, insurance companies, pharmacy staff, and physicians regarding denials, as well as working with providers and staff to resubmit paperwork to obtain a determination.
- Notify patients, providers and front office staff prior to date of service if referrals, precertification, or prior authorizations are not approved.
- Remain up to date on outpatient billing and benefit changes for third-party insurance carriers. Maintain compliance with all government and non-government insurance company policies and procedures as they relate to outpatient services.
- Ensure correct reporting of patient diagnosis and procedure coding.
- Ensure compliance with LCD/NCDs. Communicate issues with medical necessity or other findings to providers/fellow team members, and utilization review supervisor as needed.
- Prepare and submit pharmacy claims to third party insurance carriers.
- Secure appropriate medical documentation as required by third party insurance carriers.
- Follow up with third party insurance carriers on unpaid claims or balances.
- Research payer regulations and claim guidelines on payment and claim submission criteria to ensure compliant billing practices by utilizing website and associated tools established for payers as applicable.
- Verify insurance coverage for pharmacy services prior to services being rendered.
- Ensure accurate and through documentation of steps taken to resolve prior authorization and claim issues are recorded in billing software(s).
- Monitor claims for accuracy and authorization. Communicate claim issues to team lead and/or utilization review supervisor on a regular basis.
- Work with team lead/utilization review supervisor to establish goals and communicate associated progress as needed.
Knowledge:
- Billing practices, clinic policies, and operating procedures.
- Coding and clinic operating policies.
Skills:
- Proficient in clinical and administrative software systems.
Abilities:
- Understand and interpret policies and regulations.
- Read and interpret medical charts.
- Review documents for accuracy and completeness.
- Communicate effectively and collaborate with staff and providers.
Requirements
- High school diploma or GED
- Minimum1 year related experience
Benefits
IHI is a not-for-profit program based in Indianapolis and offers a competitive salary and benefit package.
IHI is the only ederally designated comprehensive hemophilia program in Indiana, and serves the entire state through services available in Indianapolis and at outreach clinics.
IHI is a leader in hemophilia care, education and clinical research and has a dedicated on-site multidisciplinary staff to ensure availability of a wide range of required services.
IHI participates in national and international clinical research, including new infusion products and therapies, investigation of long-term outcomes, and the impact of associated conditions. The IHTC research program provides patients access to new therapies, and an opportunity to improve care. Our center has more than 70 clinical research projects involving bleeding disorders, sickle cell disease, thrombosis and more.
The Indiana Hemophilia and Thrombosis Center is an Equal Opportunity Employer.