Job Description

Job Description

Responsibilities

Lighthouse Care Center of Augusta is looking for an fantastic Utilization Review (UR) Coordinator. The UR Coordinator is a member of the Finance team. The Coordinator's responsibilities are to review clinical content of medical record, participate in treatment team meetings, collaborate with physicians, therapist, nurses and pertinent staff on gathering the necessary data to communicate with insurance companies/authorizing entities to ensure initial precertification and continued authorization is achieved. The Utilization Review Coordinator will be trained in all aspects relative to timely gathering clinical criteria, communication of clinical criteria, and entry of supporting clinical criteria into computer based systems, in addition to other job duties.

As a representative of Lighthouse Care Center of Augusta, all comments, attitudes, actions, and behaviors have a direct effect on the Facility's image and perceptions of quality service. Interaction with patients, family members, physicians, referral sources, payer sources, etc. must be in a manner that is friendly, supportive, courteous, respectful, cooperative, and professional. This behavior should promote an atmosphere of teamwork, which is congruent with facility standards and guidelines to promote positive relations. Service Excellence Customer Service is a requirement at all times.

Qualifications

POSITION REQUIREMENTS/QUALIFICATIONS:

Total education, experience and Licenses or Certifications:

Masters level education in social science field; 2 years of experience in a psychiatric health care setting in utilization review. Must be license-eligible

ENVIRONMENTAL CONDITIONS:

Activities occur inside and outside. The worker is subject to potential hazards such as volatile patients, exposure to heat outdoors, etc.

PHYSICAL REQURIEMENTS:

Physical demands require daily walking, standing, kneeling, balancing, climbing, and etc. The following applies if the incumbent directly conducts adventure-type programs such as the ROPES course. Visual Acuity - mobile equipment operators: This is a minimum standard for use with those who operate cars, trucks, forklifts, cranes, and high equipment.

Machines, Tools and Equipment used on job:

Personal computer/internet, Fax machine/copy machine

DEGREE OF SUPERVISION:

Minimum. Must be able to work independently, but also take directions