... authorization is achieved. * Ensure input of pre-certifications and continued stay reviews into ... utilization review. CERTIFICATIONS, LICENSES, REGISTRATION LMHC, LAPC, LPC, LMSW, LCSW, LPN or RN ...
... authorization is achieved. * Ensure input of pre-certifications and continued stay reviews into ... utilization review. CERTIFICATIONS, LICENSES, REGISTRATION LMHC, LAPC, LPC, LMSW, LCSW, LPN or RN ...
Utilization Review Specialist
Tucson, AZ · On-site
As a Utilization Review Specialistjoining our team, you're embracing a vital mission dedicated to ... authorization information to the appropriate resource. * Actively communicates with the ...
Utilization Review Specialist
Tucson, AZ · On-site
As a Utilization Review Specialistjoining our team, you're embracing a vital mission dedicated to ... authorization information to the appropriate resource. * Actively communicates with the ...
This position will assist in the coordination of all activities related to insurance authorizations process for the Patient Access Utilization Review (UR) department. Activities may consist of ...
This position will assist in the coordination of all activities related to insurance authorizations process for the Patient Access Utilization Review (UR) department. Activities may consist of ...
One year utilization and review experience ... Experience with MCG authorization criteria preferred. Knowledge of current nursing principles ...
One year utilization and review experience ... Experience with MCG authorization criteria preferred. Knowledge of current nursing principles ...
Utilization Review Nurse
Oxford, NC · On-site
One year utilization and review experience ... Experience with MCG authorization criteria preferred. Knowledge of current nursing principles ...
Utilization Review Nurse
Oxford, NC · On-site
One year utilization and review experience ... Experience with MCG authorization criteria preferred. Knowledge of current nursing principles ...
Utilization Review Assistant- Remote
Flint, MI · On-site +1
This position will assist in the coordination of all activities related to insurance authorizations process for the Patient Access Utilization Review (UR) department. Activities may consist of ...
Utilization Review Assistant- Remote
Flint, MI · On-site +1
This position will assist in the coordination of all activities related to insurance authorizations process for the Patient Access Utilization Review (UR) department. Activities may consist of ...
Collection of clinical information necessary to initiate commercial payer authorization. Obtain and ... Reviews hospital records daily to determine if utilization resources could be served in a better ...
Quick apply
Collection of clinical information necessary to initiate commercial payer authorization. Obtain and ... Reviews hospital records daily to determine if utilization resources could be served in a better ...
The UR Director manages utilization review activities, including precertification and continued stay authorizations, and serves as the primary point of contact for payor sources. They communicate ...
Quick apply
The UR Director manages utilization review activities, including precertification and continued stay authorizations, and serves as the primary point of contact for payor sources. They communicate ...
Manage authorization denials including referral for peer review. * Document and record all ... Utilization Review Specialist | Utilization Management Specialist | UR Specialist | Revenue Cycle ...
Quick apply
Manage authorization denials including referral for peer review. * Document and record all ... Utilization Review Specialist | Utilization Management Specialist | UR Specialist | Revenue Cycle ...
... authorization is achieved. * Ensure input of pre-certifications and continued stay reviews into ... utilization review. CERTIFICATIONS, LICENSES, REGISTRATION LMHC, LAPC, LPC, LMSW, LCSW, LPN or RN ...
... authorization is achieved. * Ensure input of pre-certifications and continued stay reviews into ... utilization review. CERTIFICATIONS, LICENSES, REGISTRATION LMHC, LAPC, LPC, LMSW, LCSW, LPN or RN ...
Utilization Review Coordinator
Norman, OK · On-site
Utilization review experience REQUIRED The Utilization Review Coordinator is responsible for ... Ensures all authorization and denied information is in HCS at the end of each business day.
Utilization Review Coordinator
Norman, OK · On-site
Utilization review experience REQUIRED The Utilization Review Coordinator is responsible for ... Ensures all authorization and denied information is in HCS at the end of each business day.
... The Utilization Review Coordinator is responsible for management of all utilization review ... Ensures all authorization and denied information is in HCS at the end of each business day.
... The Utilization Review Coordinator is responsible for management of all utilization review ... Ensures all authorization and denied information is in HCS at the end of each business day.
As a Utilization Review Specialistjoining our team, you're embracing a vital mission dedicated to ... authorization information to the appropriate resource. * Actively communicates with the ...
As a Utilization Review Specialistjoining our team, you're embracing a vital mission dedicated to ... authorization information to the appropriate resource. * Actively communicates with the ...
ABA Utilization Review (UR) Specialist
Skokie, IL · On-site +1
Manage authorization denials including referral for peer review. * Document and record all ... Utilization Review Specialist | Utilization Management Specialist | UR Specialist | Revenue Cycle ...
ABA Utilization Review (UR) Specialist
Skokie, IL · On-site +1
Manage authorization denials including referral for peer review. * Document and record all ... Utilization Review Specialist | Utilization Management Specialist | UR Specialist | Revenue Cycle ...
Collection of clinical information necessary to initiate commercial payer authorization. Obtain and ... Reviews hospital records daily to determine if utilization resources could be served in a better ...
Collection of clinical information necessary to initiate commercial payer authorization. Obtain and ... Reviews hospital records daily to determine if utilization resources could be served in a better ...
... authorization is achieved. * Ensure input of pre-certifications and continued stay reviews into ... utilization review. CERTIFICATIONS, LICENSES, REGISTRATION LMHC, LAPC, LPC, LMSW, LCSW, LPN or RN ...
... authorization is achieved. * Ensure input of pre-certifications and continued stay reviews into ... utilization review. CERTIFICATIONS, LICENSES, REGISTRATION LMHC, LAPC, LPC, LMSW, LCSW, LPN or RN ...
The UR Director will report consistently and accurately to the CEO or delegate the authorization ... Previous utilization review experience in a psychiatric healthcare facility preferred. * License:
The UR Director will report consistently and accurately to the CEO or delegate the authorization ... Previous utilization review experience in a psychiatric healthcare facility preferred. * License:
Works with the Utilization Management team primarily responsible for inpatient medical necessity ... prior authorizations and/or concurrent review. Assesses services for Molina Members to ensure ...
Works with the Utilization Management team primarily responsible for inpatient medical necessity ... prior authorizations and/or concurrent review. Assesses services for Molina Members to ensure ...
Utilization Review Coordinator
$19.96 - $24.96/hr
The Utilization Review Coordinator provides a broad range of clerical and technical support for ... Send prior service authorization acknowledgment letters * Manage calendar for grievance, concurrent ...
Utilization Review Coordinator
$19.96 - $24.96/hr
The Utilization Review Coordinator provides a broad range of clerical and technical support for ... Send prior service authorization acknowledgment letters * Manage calendar for grievance, concurrent ...
This position will assist in the coordination of all activities related to insurance authorizations process for the Patient Access Utilization Review (UR) department. Activities may consist of ...
This position will assist in the coordination of all activities related to insurance authorizations process for the Patient Access Utilization Review (UR) department. Activities may consist of ...
Authorization Utilization Review Bcba information
What are the key skills and qualifications needed to thrive in the Authorization Utilization Review Bcba position, and why are they important?
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 are the primary responsibilities of an Authorization Utilization Review BCBA on a typical day?
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 job?
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.
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 12 days ago
Universal Health Services rating
6.7
Based on 248 frontline employees who took The Breakroom Quiz
527th of 872 rated healthcare providers
Job description
Lighthouse Care Center of Augusta has been providing psychiatric services to the CSRA for more than 15-years. Located in Augusta, GA our 84-bed facility provides a therapeutic setting for those seeking treatment for mental illness. Lighthouse Care Center offers unique and individualized programming for adolescents and adults that sets us apart from many other treatment facilities, and our tenured team includes seasoned medical staff.
Website: https://www.LighthouseCareCenters.com
The Utilization Review Coordinator opportunity is a key member of the Lighthouse Case Management team who will integrate and coordinate clinical content with a keen focus on patient care; ensuring that delivery of high-quality and cost-effective treatment is consistent with the mission, vision, and values of Universal Health Services and in accordance with government regulation, licensing and accreditation requirements. Under the direction of the UR Manager, the Utilization Review Coordinator is responsible for conducting clinical review of data to determine eligibility respective to pre-certification and continued stay reviews.
Job Duties/ Responsibilities:
- Review clinical content of medical records, participate in treatment team meetings, and collaborate with physicians, therapist, nurses and pertinent staff on gathering the necessary data to communicate with insurance companies/authorizing entities to ensure initial precertification and continued authorization is achieved.
- Ensure input of pre-certifications and continued stay reviews into Midas, follow-up on unfinished pre-certifications from the day before, coordinate with the treatment team on any follow-ups necessary, verify insurance coverage at the first of the month, and post patient payments into MS4.
- Trained in all aspects relative to timely gathering of clinical criteria, communication of clinical criteria, and entry of supporting clinical criteria into computer based systems, in addition to other job duties.
Benefit Highlights
- Referral Bonus Program
- Challenging and rewarding work environment
- Competitive Compensation & Generous Paid Time Off
- Excellent Medical, Dental, Vision and Prescription Drug Plans
- 401(K) with company match and discounted stock plan
- Career development opportunities within UHS and its 300+ Subsidiaries!
- More information is available on our Benefits Guest Website: uhsguest.com
About Universal Health Services
One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (NYSE: UHS) has built an impressive record of achievement and performance, growing since its inception into a Fortune 500 corporation. Headquartered in King of Prussia, PA, UHS has 99,000 employees. Through its subsidiaries, UHS operates 28 acute care hospitals, 331 behavioral health facilities, 60 outpatient and other facilities in 39 U.S. States, Washington, D.C., Puerto Rico and the United Kingdom.
Qualifications
EDUCATION AND EXPERIENCE
Masters level education in social science field (social work, counseling, sociology, psychology). Must be license-eligible or licensed in Georgia.
Nurses with a current GA or Multistate RN license encouraged to apply.
Must have 2 years of experience in a psychiatric health care setting, delivery of care to psychiatric and/or chemically dependent patients and utilization review.
CERTIFICATIONS, LICENSES, REGISTRATION
LMHC, LAPC, LPC, LMSW, LCSW, LPN or RN preferred.
Qualifications:EDUCATION AND EXPERIENCE
Masters level education in social science field (social work, counseling, sociology, psychology). Must be license-eligible or licensed in Georgia.
Nurses with a current GA or Multistate RN license encouraged to apply.
Must have 2 years of experience in a psychiatric health care setting, delivery of care to psychiatric and/or chemically dependent patients and utilization review.
CERTIFICATIONS, LICENSES, REGISTRATION
LMHC, LAPC, LPC, LMSW, LCSW, LPN or RN preferred.
Education:UNAVAILABLEEmployment Type: FULL_TIMEWhat Universal Health Services employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About Universal Health Services
Sourced by ZipRecruiter
Universal Health Services (UHS) is a major player in the healthcare industry, based in King of Prussia, Pennsylvania, U.S. Founded in 1978, UHS offers hospital and healthcare services. Their diverse services range from acute care hospitals, behavioral health facilities and ambulatory centers nationwide. The company's mission of enhancing the health and well-being of their patients is reflected in their commitment to 'Helping Individuals Live Longer, Healthier and Happier Lives'. Universal Health Services' consistent growth and success in their industry have been recognized on numerous occasions, including being ranked amongst the Fortune 500 list of largest companies.
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
King of Prussia, PA, US