The Utilization Review Specialist is responsible for managing all aspects of the utilization review process, including preauthorization, Single Case Agreements (SCA), continued authorizations, and collaboration with clinical staff to ensure documentation meets insurance requirements. This role is crucial in securing necessary authorizations for various levels of care, advocating for clients with insurance providers, and supporting the clinical team through training on medical necessity and documentation best practices. Work with outside agencies and third-party contractors as indicated or needed.
Job Duties:
Preauthorization:
Single Case Agreements (SCAs):
Continued Authorizations:
Clinical Staff Collaboration:
Training and Education:
Client Advocacy:
Compliance and Reporting:
Complete additional tasks as assigned or needed.
Minimum Qualifications:
This is a full time role
Up to $6/hr
100% Remote Work
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