Utilization Review Specialist
The Right Step - Dallas, TX

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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.

Responsibilities:

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.

Qualifications:
  • 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.

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Where Putting an End to Addiction Is Just the Beginning. The Right Step has been delivering affordable, quality treatment solutions for...