Silver Pines Treatment Center is a detox and residential program providing comprehensive addiction treatment and care. We are currently seeking a full-time experienced Utilization Review Analyst with excellent organizational and communication skills. This position will work out of our Levittown office.
Responsibilities of this position include:
- Reviewing admissions to determine medical necessity and appropriateness of treatment.
- Submitting pre-assessments to the insurance company for initial authorizations.
- Regularly reviewing client charts.
- Presenting clinical course of treatment and clients needs to insurance companies
- Reviewing, abstracts and assigning initial length of stay and extensions of treatment, as appropriate, self-pay and private insurance companies.
- Communicating all extensions of treatment to clinical teams and billing team
- Tracking and reporting authorization trends by insurance company
- Giving clinical team feedback on clinical charts and authorizations in an effort to enhance their knowledge base and understanding of insurance guidelines.
- High School Diploma required, BA in psychology or related field preferred
- Minimum of 1 year experience providing direct care to clients.
- Expert in ASAM and insurance measures that will dictate LOC
- Minimum of 3-5 years in UR department
- Ability to interpret chart terminology
- Excellent Knowledge of addiction
- Proficient in Microsoft word and Excel
- Understanding and familiarity of basic EMR software
Silver Pines Treatment Center is an Equal Opportunity Employer that does not discriminate on the basis of actual or perceived race, creed, color, religion, alienage or national origin, ancestry, citizenship status, age, disability or handicap, sex, marital status, veteran status, sexual orientation, gender identity, genetic information, arrest record, or any other characteristic protected by applicable federal, state, or local laws.
Silver Pines Treatment Center