UR/ Aftercare Coordinator

UR/ Aftercare Coordinator
Pyramid Healthcare, United States

Experience
1 Year
Salary
0 - 0
Job Type
Job Shift
Job Category
Traveling
No
Career Level
Telecommute
No
Qualification
As mentioned in job details
Total Vacancies
1 Job
Posted on
Apr 1, 2021
Last Date
May 1, 2021
Location(s)

Job Description

Freedom Detox is looking for a UR Coordinator to join our dynamic team. We pride ourselves on offering highly individualized treatment to meet each client’s needs. At the heart of our program is a team of licensed and experienced professionals who offer each client at Freedom Detox a unique, person-focused plan for recovery.


Responsibilities:

  • Conduct admission, continued stay and discharge reviews on all managed care clients.
  • Maintain positive relationships with referral sources and insurance companies.
  • Track admissions, continued stay and discharge PCPC requirements for county referrals.
  • Maintain organized system of reporting to counselors when PCPC’s are due and when review calls are to be made.
  • Monitor census for accuracy of level of care and funding issues.
  • Attend clinical staffing to obtain information for client reviews.
  • Maintain daily UR database accurately.
  • Maintain current insurance eligibility information through EVS, Navinet, etc.
  • Monitor census for accuracy of funding.
  • Perform Act 106 reviews and follow up appeals.
  • Track all county referrals for documentation of admission calls.
  • Maintain and participate in chart reviews to ensure proper paperwork is in place.
  • Work directly with the Billing department to reduce uncovered days of funding.
  • Investigate cases with insurance and referral sources to recuperate lost days of funding.
  • Report to the Program Director on a monthly basis via the UR report.
  • Other duties as deemed necessary
  • Provide the company with accurate information to ensure full financial coverage for each client day.
  • Provide the referral source(s) with timely information to ensure good customer focus.
  • Maintain client confidentiality and provide a safe therapeutic treatment.
  • Will Provide Direct Care to clients.
  • Requirements

    • Associate Degree or equivalent required. Bachelor of Science in Behavioral Health, RN, LPC, or LCSW is preferred.
    • Intermediate knowledge of computer skills and the internet, Microsoft Office experience, Excel- Intermediate level, Word- Intermediate level.
    • 3-5 years’ experience as a UR Coordinator or related position in a similar healthcare setting.
    • Knowledge of local, state and federal regulations.
    • Knowledge of medical terminology, appeal and denial process, composition of medical records.
    • Knowledge of pre-certification process and PCPC. Possesses excellent verbal and written communication skills.
    • Knowledge of CARF standards, release of information and confidentiality.
    • Knowledge of DSM IV, private care managers and county referral sources.

    Benefits

    Medical, Vision, Dental, Life

    401K

    Paid Days Off

    Tuition Reimbursement

    And more!

    Job Specification

    Job Rewards and Benefits

    Pyramid Healthcare

    Information Technology and Services - San Jose, United States
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