Utilization Review Coordinator jobs in Connecticut

The Utilization Review Coordinator is responsible for maintaining clients continued insurance coverage for the duration of their treatment stay based upon ASAM criteria. Serves as a resource person for the health care team by completing concurrent reviews and updating them on insurance information.

Job Duties

• Promote the mission, vision, and values of the organization
• Knowledgeable of criteria for RTC, PHP, and IOP private insurance coverage.
• Complete concurrent reviews to keep clients at RTC, PHP, and IOP level of care
• Participates in interdisciplinary clinical team meetings to discuss each client’s active treatment and review of medical necessity.
• Communicate daily with admissions personnel regarding insurance coverage.
• Strong analytical, organizational and time management and computer skills.
• Ability to negotiate medical necessity on behalf of the client.
• Serve as liaison for billing company for the duration of the client’s length of stay.
• Informs medical/psychiatric staff when a peer review must be completed.
• Compiles and maintains data as needed or when requested.

Minimum Qualification:

• College degree
• Attention to detail and ability to multitask.
• Ability to answer phone calls, emails and other daily correspondence.
• Capable of communicating to business associates at all levels. Maintain confidentiality regarding clients, insurance, residents and associates.
• Interest in non-profit and social services.
• Skills in Microsoft Word, Excel and PowerPoint
• Ability to maintain high standards of productivity, cooperation, attendance and efficiency in work habits.

Job Type: Full-time

Healthcare setting:

• Inpatient
• Outpatient

Schedule:

• 8 hour shift
• Day shift
• Holidays
• Monday to Friday
• Weekends as needed

Experience:

• Utilization review: 1 year (Required)

Work Location: In person