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Utilization Review Specialist
Location:
US-UT-Springville
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Helping families heal.

We believe it. We live it.

______________________________________________

Full-time | M-F 9am - 5 pm | $18-20/hour | Benefits

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The Ascent Programs are a group of licensed, accredited therapeutic program located in Utah. We have 25+ years of experience using evidence-based practices to help families heal. As our Utilization Review Specialist, you will responsible for maintaining organizational compliance and following all HIPPA regulations while providing compassionate service.

Many families need help with their child's mental health but don't know where to start. As our Utilization Review Specialist, you play a crucial role in helping make this life-saving treatment accessible. This may mean walking a parent through what services we offer or working with insurance companies to get reimbursements for families. A successful Utilization Review Specialist will enhance the quality of patient management, maximize satisfaction, and promote cost effectiveness while working across clinical teams and departments.

Responsibilities:

  • Assist admissions in ensuring prospective clients are clinically appropriate
  • Gather and present data necessary to obtain a precertification authorization with third party payers
  • Ensure clinical data and case notes support clinical needs and clients are receiving proper therapeutic interventions
  • Present case information to third-party payers (insurance) for review
  • Schedule and conduct concurrent reviews
  • Participate in Treatment Team meetings and assist with discharge planning
  • Assist clinical teams in peer review
  • Keep team members informed of the status of current patient authorizations, length of stay, upcoming review dates, and questions from the paying party
  • Maintain thorough documentation of all utilization activities
  • Participate in performance improvement activities
  • Respond to customer inquiries both telephone and by email
  • Assess required clinical and financial information using available resources
  • Work within an established lead management software system

Requirements

  • College Degree (Associate or higher)
  • Able to pass background criminal investigation checks
  • Eligible to work in the USA
  • Proficient in basic computer programs
  • Proficient in communicating, both verbally and in writing, in English
  • Reflective listening skills
  • Empathetic
  • Clear, honest communication

Preferred

  • Some college in Social Work or Psychology
  • Professional experience in a treatment facility (wilderness, RTC, etc.)

Benefits

  • Small, close knit team
  • Health, dental, vision, accident, critical illness, and other insurance plans available after probationary period for full-time employees
  • Employer contributions to Health Savings Account (HSA)
  • Free Employee Assistance Program (EAP)
  • Significant discounts for hundreds of professional gear brands

Redcliff Ascent

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