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Authorization Utilization Review Bcba Jobs (NOW HIRING)

... 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 ...

... 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 ...

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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.

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Utilization Review Coordinator

Utilization Review Coordinator

UHS

Augusta, GA

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 12 days ago


Universal Health Services rating

6.7

Company rating: 6.7 out of 10

Based on 248 frontline employees who took The Breakroom Quiz

527th of 872 rated healthcare providers


Job description

Responsibilities

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_TIME

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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