Prior Authorization Rn Jobs in El Paso, TX (NOW HIRING)

The Intake Clinician is a behavioral health professional responsible for facilitating admissions, conducting clinical intake assessments, and managing the prior authorization process to ensure patients receive the most appropriate level of care. This role handles daily intake and admissions operations, which may include screening, scheduling, financial counseling, and insurance verification. Intake Clinicians are responsible for completing assessments both at the facility and off-site as needed, screening for clinical and medical appropriateness and communicating assessment results to a physician, who determines the appropriate level of care. The Intake Clinician works closely with the business office, nursing, clinical staff, and external parties to ensure patients are admitted promptly and efficiently.

• Facilitates intake, admission, and prior authorization process for incoming patients.
• Performs insurance benefit verifications, disseminating the information gathered to patients, their families, and appropriate internal staff.
• Provides additional coverage for the Call Center Team – e.g. answers phones, processes admission requests, completes call center duties reviewing and accepting patients, verifies insurance, and assists with insurance pre-certifications during times of high volume.
• Provides accurate and ongoing assessment of patient’s status in the admission and prior authorization process.
• Facilitates the response to requests for services, including the initial response, the assessment and referral process, the designation of appropriate level of care, initiation/intake into services, and appropriate follow up activity.
• Follows EMTALA regulations to complete insurance verification and precertification’s, when appropriate.
• Responds to inquiries about the facility within facility policy timeframes.
• Schedules/completes pre-admission assessments and communicates recommendations to patients or their family.
• Collaborates with other facility medical and psychiatric personnel to ensure appropriate recommendations and admissions.
• Performs ongoing assessments of physical/function, emotional, social, spiritual and financial needs of patients and implements crisis intervention and referral.
• Provides education regarding healthcare and social resource systems to empower patients and their family to access resources independently.
• Maintains all the documentation involved with the admissions process.

Master’s Degree from an accredited college or university in social work, counseling, psychology, mental health or a related field required. In some states, may also be a registered nurse, in which case, an associate's or bachelor's degree in nursing is required. One or more years’ experience in mental/behavioral health working with individuals in a clinical or observational capacity preferred. Experience in the managed care pre-certification process, level of care assessments and utilization preferred. Experience in clinical interviewing, patient assessment, referral, treatment planning, communicating with external review organizations or comparable entities, and working effectively with people of diverse backgrounds. Outstanding interpersonal and interviewing and assessment skills. Skill in telephone etiquette and paging procedures.

Current licensure, as required for the area of clinical specialty, i.e., current RN license, LCSW, LPC or other clinical counseling or therapy license, as designated by the state in which the facility operates. CPR and de-escalation and restraint certification required (training available upon hire and offered by facility). First aid may be required based on state or facility requirements.

This position is onsite and is not a remote position.

This position is an Individual Contributor.

• Peak Behavioral Health offers a comprehensive benefit plan and a competitive salary commensurate with experience and qualifications.

Peak Behavioral Health is an EOE.

Summit BHC is dedicated to serving Veterans with specialized programming at our treatment centers across the country. We recognize and value the unique strengths of the military community in supporting our mission to serve those who have served.