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Utilization Review Specialist - LPN Required

Role overview

Qualifications

  • Strong knowledge of levels of care
  • Experience with prior authorization processes
  • Familiarity with behavioral health policies

Responsibilities

  • Conducting Utilization Reviews for behavioral health services
  • Reviewing cases via multiple platforms
  • Coordinating peer reviews
  • Entering authorization data and following up on approvals

Key facts

Hard skills

Other skills

  • Communication
  • Coordinating

About the company

Medusind Inc. logo

Medusind Inc.

Medusind is a leading medical and dental billing and revenue cycle management company. We help organizations maximize revenue and reduce operating costs. Our highly trained team of experts brings deep expertise, 1:1 dedicated services and full transparency and data tracking. Our unique combination of powerful technology solutions and client-focused service significantly improves the efficiency and profitability of medical practices, hospitals, dental groups, GPOs and third-party administrators. Client satisfaction is the primary focus of the Medusind leadership and staff. Our detailed eye for processes, highly experienced personnel, cutting edge technology and forward thinking approach allows us to deliver effective solutions while staying ahead of healthcare industry changes. ➤ More than 3,000 dedicated employees including our physician-led coding team staffed by AAPC certified coders with expertise in CPT, ICD-10, HCPCS level II and DRG codes across various specialties. ➤ Leading edge technology including our MedClarity PM, PracticeGenie EMR and QuickVerify dental eligibility solution. ➤ 12 locations across the US and India - Miami, Orlando, Sarasota, Los Angeles, Fort Worth, Oklahoma City, Newark, Roanoke, Mumbai, Chennai, Ahmedabad, Coimbatore ➤ We provide services to more than 6,000 healthcare providers across all specialties ➤ ISO 27001 Certified and HIPAA compliant

Company details

Company typeXLarge
Company size1001 - 5000

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Job description

Position Overview:

The UR Representative is responsible for conducting Utilization Reviews (UR) to ensure appropriate authorization for behavioral health services. This role involves reviewing cases via multiple platforms, coordinating peer reviews, entering authorization data, following up on approvals, and maintaining clear communication with facilities. Strong knowledge of levels of care, prior authorization processes, and behavioral health policies is required.          

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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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