Description3034464: Utilization Insurance Specialist -Psychiatry Child Inpatient Unit -MSM- Full Time Day
Job Summary:
To provide clinical information to Managed Care/Insurance Companies/BHO to demonstrate medical necessity and ensure reimbursement.
ResponsibilitiesResponsible for all aspects of the concurrent review program, insurance certification, and authorization process for all Psychiatric or Chemical Dependency Inpatient Units (subject to assignment by management) and for all aspects of the initial review on an as needed basis Develops rapport with and daily working relations Admitting and Inpatient clinicians to insure ongoing, comprehensive clinical information if both documented and available in timely fashion to facilitate initial clinical reviews, pre-certifications and authorizations to admit to inpatient as well as continuing stay review approvals and authorizations Maintains daily communications and doc...