A company is looking for a UR Specialist to join their team.
Key Responsibilities
Evaluate patient medical records to determine the necessity and appropriateness of services
Analyze utilization data to identify trends and provide recommendations for improvement
Communicate with providers and insurance companies to manage utilization reviews and resolve coverage issues
Required Qualifications
Experience in healthcare, preferably in behavioral health
Minimum of one year experience in utilization review
Familiarity with billing and EMR / EHR software
Knowledge of standard medical necessity criteria
Adherence to confidentiality standards regarding patient care information
Behavioral Health Specialist • Greensboro, North Carolina, United States