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Authorization Utilization Review Bcba Jobs in Indiana

Lifepoint Health

Utilization Review Specialist

Lafayette, IN · On-site

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

... you'll contribute Utilization Review Specialist facilitates clinical reviews on all patient ... Reports appropriate denial, and authorization information to designated resource. * Actively ...

Lifepoint Health

Specialist, Utilization Review

Newburgh, IN · On-site

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Previous utilization review experience in a psychiatric healthcare facility preferred. * License ... Reports appropriate denial, and authorization information to designated resource. * Actively ...

Lifepoint Health

Utilization Review Specialist

Lafayette, IN · On-site

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

... you'll contribute Utilization Review Specialist facilitates clinical reviews on all patient ... Reports appropriate denial, and authorization information to designated resource. * Actively ...

Briljent

Clinical Domain Project Manager (PBM)

Indianapolis, IN · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Assigned projects span drug coverage administration, Preferred Drug List (PDL) management, prior authorization, utilization management, drug utilization review, clinical criteria configuration, and ...

Briljent

Clinical Domain Project Manager (PBM)

Indianapolis, IN · On-site +1

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Assigned projects span drug coverage administration, Preferred Drug List (PDL) management, prior authorization, utilization management, drug utilization review, clinical criteria configuration, and ...

Damar Services, Inc.

BCBA

Indianapolis, IN

$70K - $86K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

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 ...

Damar Services, Inc.

BCBA

Indianapolis, IN · On-site

$70K - $86K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

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 ...

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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.

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Authorization Utilization Review Bcba jobs near you

Utilization Review Specialist

Lifepoint Health

Lafayette, IN • On-site

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 6 hours ago

LifePoint Health rating

6.0

Company rating: 6.0 out of 10

Based on 271 frontline employees who took The Breakroom Quiz

748th of 887 rated healthcare providers

Job description


Your experience matters
At Sycamore Springs, we are committed to empowering and supporting a diverse and determined workforce who can drive quality, scalability, and significant impact across our hospitals and communities. In your role, you'll support those that are in our facilities who are interfacing and providing care to our patients and community members. We believe that our collective efforts will shape a healthier future for the communities we serve.
What we offer
Fundamental to providing great care is supporting and rewarding our team. In addition to your base compensation, this position also offers:
  • Health (Medical, Dental, Vision) and 401K Benefits for full-time employees
  • Competitive Paid Time Off
  • Employee Assistance Program - mental, physical, and financial wellness assistance
  • Tuition Reimbursement/Assistance for qualified applicants
  • And much more...

About Us
People are our passion and purpose. Sycamore Springs is a 48 bed hospital located in Layfette, IN and is part of Lifepoint Health, a diversified healthcare delivery network committed to making communities healthier® with acute care, rehabilitation, and behavioral health facilities from coast to coast. From your first day to your next career milestone-your experience matters
How you'll contribute
Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued stays. UR analyzes patient records to determine legitimacy of admission, treatment, and length of stay and interfaces with managed care organizations, external reviewers and other payers. UR advocates on behalf of patients with substance abuse, dual diagnosis, psychiatric or emotional disorders to managed care providers for necessary treatment. UR contacts external case managers/managed care organizations for certification of insurance benefits throughout the patient's stay and assists the treatment team in understanding the insurance company's requirements for continued stay and discharge planning.
Essential Functions:
  • Displays knowledge of clinical criteria, managed care requirements for inpatient and outpatient authorization and advocates on behalf of the patient to secure coverage for needed services
  • Completes pre and re-certifications for inpatient and outpatient services. Reports appropriate denial, and authorization information to designated resource.
  • Actively communicates with interdisciplinary team to acquire pertinent information and give updates on authorizations.
  • Participate in treatment teams to ensure staff have knowledge of coverage and to collect information for communication with agencies.
  • Works with DON to ensure documentation requirements are met.
  • Ensure appeals are completed thoroughly and on a timely basis.
  • Interface with managed care organizations, external reviews, and other payers.
  • Communicate with physicians to schedule peer to peer reviews.
  • Accurately report denials.

Qualifications and requirements
Bachelor's Degree
Previous utilization review experience in a psychiatric healthcare facility preferred.
EEOC Statement:
Sycamore Springs is committed to providing Equal Employment Opportunities for all applicants and employees and complies with all applicable laws prohibiting discrimination against any employee or applicant for employment because of color, race, sex, age, religion, national origin, disability, genetic information, gender identity, sexual orientation, veterans' status or any other basis protected by applicable federal, state or local law.
About Us
Lifepoint Health is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.
About the Team
We employ and provide care to people from all walks of life. We are committed to promoting healing, providing hope, preserving dignity and producing value with an inclusive workforce in which diversity is leveraged, respected, and reflective of the patients, family members, customers and team members we serve.

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Hours and flexibility

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About LifePoint Health

Sourced by ZipRecruiter

Lifepoint Health serves patients, clinicians, communities and partners across the healthcare continuum. Our diversified healthcare delivery network extends from coast to coast, consisting of community hospitals, rehabilitation and behavioral health hospitals, and additional sites of care.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Brentwood, TN, US

Year founded

1999

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