Utilization Precertification Coordinator-FT
Houston Behavioral Healthcare Hospital, United States

Houston Behavioral Healthcare Hospital (HBHH) is unique in so many ways. Our facility is located in a serene, picturesque setting within the Spring Branch District of West Houston. We have highly qualified caring staff ready to provide exceptional service.

The team at Houston Behavioral Healthcare Hospital strives to be the leaders in Behavioral Health by delivering quality services to those entrusted in our care. By embarking on a path with our community and ensure Compassion, Acceptance, Respect, Empowerment, and Sincerity with each step we take together.

Houston Behavioral Healthcare Hospital (HBHH) currently has an opening for Fulltime Utilization Precertification Coordinator.

The Utilization Precertification Coordinator will report to the Director of Utilization Review and will be responsible for obtaining prior authorizations for all procedural orders by successfully completing the authorization process with all commercial payers.

Duties:

• Review chart documentation to ensure patient meets medical policy guidelines
• Prioritize incoming authorization requests according to urgency
• Obtain authorization via payer website or by phone and follow up regularly on pending cases
• Maintain individual payer files to include up to date requirements needed to successfully obtain authorizations
• Initiate appeals for denied authorizations
• Respond to clinic questions regarding payer medical policy guidelines
• Confirm accuracy of CPT and ICD-10 diagnoses in the procedure order
• Contact patients to discuss authorization status
• Other duties as assigned

Knowledge, Skills and Abilities:

• Knowledge of procedure authorization and its direct impact on the practice’s revenue cycle
• Understanding of payer medical policy guidelines while utilizing these guidelines to manage authorizations effectively
• Basic understanding of human anatomy, specifically musculoskeletal
• Proficient use of CPT and ICD-10 codes
• Excellent computer skills including Excel, Word, and Internet use
• Detail oriented with above average organizational skills
• Plans and prioritizes to meet deadlines
• Excellent customer service skills; communicates clearly and effectively
• Ability to multitask and remain focused while managing a high-volume, time-sensitive workload

Requirements

1 years experience in a medical related field and/or prior authorization experience preferred.

Experience in a Psychiatric setting.

Knowledge of healthcare service delivery systems, and third party reimbursement.

Knowledgeable of Managed Care Environment.

Benefits

401-K Plan

Medical

Vision

Dental

Ticket at Work

STD/LTD

Job Rewards and Benefits