The purpose of this position is to obtain authorization for precertification and concurrent review for all levels of care and to perform detox assessments and provide consultation for admissions.
Obtains pre-certification and concurrent review for assigned case load.
- Provides timely documentation for all acrivities related to pre-certification, concurrent review and authorization.
- Collaborates with the Admissions Department to assist in obtaining criteria for admission and referral for appropriate level of care to maximize benefits.
- Coordinates schedules and participates in peer reviews.
- Ensures timely completion of appeals process, follow-up, and resolution of outstanding authorization/claims.
- Performs detox assessments
- Verifies with insurance companies to ensure all data colected on clients is accurate.
- Assists admissions when needed
- Provides and leads CD Educations groups
- Serves as a liaison wth managed care organizations through staff education-documentation and managed care criteria guidelines.
- High School or GED equivalent
- Combination of education and experience to equal two years
- Knowledge of 12 step programs and utilization management preferred.
- Licensed Vocational Nurse or Registered Nurse in the State of Texas or Counselor LCDC or Counselor intern preferred.
Where Putting an End to Addiction Is Just the Beginning.
The Right Step has been delivering affordable, quality treatment solutions for...