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Clinical Insurance Reviewer Lmhc Jobs in Springfield, MA

Seven Hills Foundation

Clinical Director

Barre, MA · On-site

$85K - $95K/yr

Health Insurance: Offered through Blue Cross Blue Shield , with generous company contribution ... Review clinical progress notes for clinicians as needed. Review and counter sign all clinical ...

Seven Hills Foundation

Clinical Director

Barre, MA

$85K - $95K/yr

Health Insurance: Offered through Blue Cross Blue Shield , with generous company contribution ... Review clinical progress notes for clinicians as needed.Review and counter sign all clinical ...

Seven Hills Foundation

Clinical Director

Barre, MA · On-site

$85K - $95K/yr

Health Insurance: Offered through Blue Cross Blue Shield , with generous company contribution ... Review clinical progress notes for clinicians as needed. Review and counter sign all clinical ...

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Clinical Insurance Reviewer Lmhc information

What are the key skills and qualifications needed to thrive as a Clinical Insurance Reviewer (LMHC), and why are they important?

To excel as a Clinical Insurance Reviewer (LMHC), you need a master's degree in mental health counseling, a valid LMHC license, and strong knowledge of clinical documentation and insurance regulations. Familiarity with utilization review software, electronic health records (EHRs), and payer-specific guidelines is typically required. Exceptional attention to detail, analytical thinking, and effective written communication are crucial soft skills for this role. These competencies ensure accurate case evaluations, compliance with regulatory standards, and efficient collaboration with providers and insurers.

What are some typical challenges faced by a Clinical Insurance Reviewer LMHC, and how can they be managed?

A Clinical Insurance Reviewer LMHC often encounters challenges such as navigating complex insurance policies, meeting strict deadlines for case reviews, and balancing clinical best practices with insurance requirements. Managing these challenges involves staying up-to-date with evolving insurance regulations, maintaining strong organizational skills, and collaborating closely with both clinical teams and insurance representatives. Building clear communication channels and regularly updating documentation can also help streamline the review process and minimize misunderstandings.

What are Clinical Insurance Reviewer LMHCs?

Clinical Insurance Reviewer LMHCs (Licensed Mental Health Counselors) are professionals who evaluate mental health treatment claims for insurance companies. They review clinical documentation to determine if the services provided meet medical necessity criteria and insurance policy guidelines. These reviewers ensure that treatment plans are appropriate, comply with regulations, and that claims are processed accurately. Their work helps balance quality patient care with insurance requirements, often serving as a liaison between providers, patients, and insurance representatives.

What is the difference between Clinical Insurance Reviewer LMHC vs Mental Health Case Manager?

AspectClinical Insurance Reviewer LMHCMental Health Case Manager
CredentialsLMHC license, clinical training, insurance knowledgeOften licensed mental health professional, may also hold LMHC
Work EnvironmentInsurance companies, healthcare organizations, review settingsCommunity agencies, hospitals, outpatient clinics
Job FocusReviewing insurance claims, determining coverage, clinical assessmentCoordinating care, providing support, connecting clients to services

The Clinical Insurance Reviewer LMHC primarily evaluates insurance claims and coverage based on clinical assessments, working within insurance companies or healthcare organizations. In contrast, a Mental Health Case Manager focuses on coordinating client care and connecting individuals to mental health services. While both roles require mental health licensure, their daily tasks and work environments differ significantly.

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Clinical Insurance Reviewer Lmhc jobs near you

Outpatient Clinician - LCSW, LICSW, LMHC

Center for Human Development

West Springfield, MA • On-site

$38/hr

Full-time

Medical, Dental, Life, PTO

Posted 26 days ago

Job description

The Center for Human Development (CHD), Outpatient Behavioral Health Clinic in West Springfield is hiring part-time and full-time clinicians to join our integrated care team!
Now offering a $2,500 sign on bonus - ask us for details!
Role Responsibilities:
We are seeking Licensed Eligible, LCSW, LICSW, LMHC licensed and fee-for-service clinicians to join the West Springfield Clinic's integrated care team. Clinicians are responsible for providing individual, couple, family, or group therapy to both child and adult populations, using evidence-based practices. This role will work collaboratively with psychiatrists, case managers, recovery coaches, and a medical team. Candidates must be compassionate, strong in communication and collaboration, able to work with diverse populations, and adaptable.
Benefits:
  • Productivity Bonuses
  • Paid Holidays
  • Generous Paid Time Off
  • Health & Dental Insurance
  • Flexible Spending Accounts (FSA)
  • Employee Wellness Benefits
  • CHD is a PSLF qualifier!
  • And much more!

Job Types: Flexible schedule available. Full-time or part-time available. Nights and Saturdays are available.
Requirements: Licensed Eligible orMassachusetts LCSW, LICSW, or LMHC.
Salary: Starting rates flexible with experience/licensure:
  • Licensed Eligible Clinician's - starting at $60,000
  • LCSW starting at $62,000
  • Independently licensed starting at $65,000
  • Fee-for-Service starting at $38/billed hour

Locations: West Springfield, MA
Hours: Flexible; Full-time, part-time, or fee-for-service, with evening and weekend hours
available.
Take advantage of a competitive compensation based on experience and credentials. As well as a phenomenal benefit package that includes, Dental, Health and Life insurance. Paid time off, earned vacation time and paid holidays just to name a few.
At Center for Human Development, (CHD) Care Finds a Way:
The Center for Human Development (CHD) provides a broad range of high quality, community-oriented human services dedicated to promoting, enhancing, and protecting the dignity and welfare of people in need. At CHD we are celebrating differences, inclusion is not just a policy- it is a daily practice. Multicultural, multilingual, and fluent in sign language, CHD is a reflection of those we serve.
Connect with our team today!
If this sounds like the right job for you, do not wait - apply today to join our team. We look forward to hearing from you!
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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