Utilization Review Specialist - Addiction Recovery

Anabranch Recovery Center

Terre Haute, Indiana, US
Utilization review and management
Coordination with insurance providers
Documentation and record maintenance
The Utilization Specialist is responsible for reviewing admissions, continued stays, utilization practices, and discharge planning according to clinically valid criteria to obtain authorizations and complete processes

Job Summary

  • The Utilization Specialist is responsible for reviewing admissions, continued stays, utilization practices, and discharge planning according to clinically valid criteria to obtain authorizations and complete processes.
  • This role involves coordinating utilization review activities to improve collection, reimbursement, and presentation of utilization review information while educating hospital staff about requirements and trends.
  • Anabranch Recovery Center offers a comprehensive benefit plan and a competitive salary commensurate with experience and qualifications, and encourages veterans and military spouses to apply.

Matching Summary

The Utilization Specialist is responsible for reviewing admissions, continued stays, utilization practices, and discharge planning according to clinically valid criteria to obtain authorizations and complete processes.

Skills & Requirements

Must-have

  • Utilization review and management
  • Coordination with insurance providers
  • Documentation and record maintenance
  • Discharge planning and care coordination
  • Monitoring length of stay and treatment coverage

Nice-to-have

  • Experience with ASAM criteria
  • Education of hospital staff
  • Collaboration with business office
  • Support for audits and peer reviews
  • Liaison between clinical teams and insurers

Key Requirements

  • High School Diploma or equivalent
  • 1+ year clinical experience in substance use or behavioral health
  • Experience with ASAM criteria preferred
  • Utilization Review experience preferred

Work Rights

Not specified

Tailored Resume

Cover Letter