Utilization Review Coordinator - Full time days
Lakeside Behavioral Health System - Memphis, TN

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Facility Information:

Since 1976 Lakeside Behavioral Health System has been the premier provider of specialized behavioral health and addictive disease services in the Memphis and mid-south region. The 295 bed facility is located on a safe and private 37 acre campus in northeast Shelby County and provides comprehensive behavioral health treatment for adults, seniors, adolescents and children. Lakeside's specialized programs treat disorders such as depression and anxiety, as well as addictive disease disorders such as alcoholism and drug addiction. At Lakeside, we believe in offering a variety of options to our patients, making our programs more accessible and our treatment more effective, while maintaining high levels of quality care. Lakeside Behavioral Health System is accredited by the Joint Commission on Accreditation of Healthcare Organizations, certified by Medicare, and licensed by the State of Tennessee.

Job Description :

The UR Coordinator possesses knowledge of psychiatric clinical diagnosis and the ability to articulate those indicators professionally. The UR Coordinator evaluates patient medical records to determine severity of patient’s illness and determining the appropriateness of level of care. Serves as liaison for patients and hospital with insurance companies. Negotiates and advocates for patient length of stay and level of care. Oversees utilization review activities with other departments to ensure reimbursement for services provided by the hospital. The UR Coordinator leads physician weekly staffing meetings and coordinates with physician’s outpatient offices for the purposes of billing. The UR Coordinator has a working knowledge of all levels of care offered and appropriately manages patient benefits.

Requirements

Job Requirements:

Master's in social science or RN required. Qualified candidate must be a self-starter and able to work independently. Must have excellent verbal and interpersonal communication skills and strong organizational and analytical skills. Experience in case management preferred. Must possess knowledge of psychiatric care, utilization review and insurance reimbursement procedures. Basic computer skills necessary.

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