ABA Utilization Review Specialist
频谱票发行解决方案为医疗保健提供商提供业界领先的收入周期管理服务。我们的团队拥有深入的行业知识，技术和经验，以确保客户收入周期以最有效和简单的方式进行管理。我们正在寻求将 ABA 利用审查专家加入到我们的不断增长的团队中.ABA 利用评估专家将利用他的知识和技能来审查临床信息并获得 ABA 及相关服务的初步和持续授权。理想候选人是热情，激励，细节导向和有兴趣在一个凝聚在一起的和有益的环境中工作。你的责任：·审查患者录取和临床信息以确保医疗必要性和使用审查指南的遵守。·获得治疗服务初步和持续授权。·管理拒绝授权，包括推至同行评估。·记录并记录所有必要信息。·监测和跟踪新和正在进行的授权案件。·与临床工作人员合作和沟通以确保获取必要信息和及时进行审查。·协助外部客户了解支付者要求的授权。· 保持患者信息的保密性，遵守 HIPAA 规定。我们提供的：· 灵活的工作环境 · 竞争力薪水 · 一支由有才华和技能的人组成的紧密团队。· 增长机会 · 福利 医疗，牙科，视觉 · 灵活性付费时间 · 401K 与公司匹配 ·补充福利资格：· 3-5年的使用审查经验。· ABA 和/或行为健康经验优先。· 大专或修士学位优先。· 高级书面和口头沟通技巧 · 注意细节以确保必要信息被捕获并适当记录。· 在团队内工作的能力。· 能力多任务，优先考虑和满足预期期限。· 认真了解保险福利和覆盖范围。·强大的计算机技能 （Word,Excel,账单软件）.使用审查专家。
查看英文原文
Spectrum Billing Solutions offers industry-leading revenue cycle management services for healthcare providers. Our team has deep industry knowledge, technology, and experience to ensure our client’s revenue cycle is managed in the most efficient and streamlined manner.
We are seeking to add an ABA Utilization Review Specialist to our growing team. The ABA Utilization Review Specialist will utilize his or her knowledge and skills to review clinical information and obtain initial and continuing authorizations for ABA and related services. The ideal candidate is passionate, motivated, detail-oriented and interested in working in a cohesive and rewarding environment.
This is a fully remote or office/home hybrid position.
Your Responsibilities:
· Review patient admission and clinical information to ensure medical necessity and compliance of utilization review guidelines.
- Obtain initial and continuing authorization for treatment services.
- Manage authorization denials including referral for peer review.
- Document and record all necessary information.
- Monitor and track new and ongoing authorization cases.
- Collaborate and communicate with clinical staff to ensure necessary information is obtained and timely reviews are performed.
- Assist external clients in understanding payer requirements for authorizations.
- Participate in team meetings.
- Maintain confidentiality of patient information and adhere to HIPAA regulations.
What we offer you:
· Flexible work environment
- Competitive Salary
- A close-knit team of talented and skilled individuals.
- Growth opportunities
- Benefits – Medical, Dental, Vision
- Flexible Paid Time Off
- 401K with Company match
- Supplemental Benefits
Qualifications:
· 3-5 years of Utilization Review experience.
- ABA and/or Behavioral Health experience preferred.
- Bachelor’s or master’s degree preferred.
- Superior written and oral communication skills
- Attention to detail to ensure necessary information is captured and properly documented.
- Ability to work independently and within a team.
- Ability to multi-task, prioritize and meet expected deadlines.
- Solid understanding of insurance benefits and coverages.
- Strong computer skills (Word, Excel, billing software).
Utilization Review Specialist | Utilization Management Specialist | UR Specialist | Revenue Cycle Specialist | Insurance Specialist | UR Specialist | Revenue Cycle Utilization Review Specialist | ABA Utilization Review Specialist | ABA Utilization Management Specialist | ABA UR Specialist | Behavioral Health Billing Specialist
#UtilizationReviewSpecialist | #UtilizationManagementSpecialist | #URSpecialist | #RevenueCycleSpecialist | #InsuranceSpecialist | #URSpecialist | #RevenueCycleUtilizationReviewSpecialist | #ABAUtilizationReviewSpecialist | #ABAUtilizationManagementSpecialist | #ABAURSpecialist | #BehavioralHealthBillingSpecialist
Originally posted on Himalayas