Greenleaf Center Utilization Review Specialist
Company: Camp Recovery
Posted on: June 7, 2021
Act as liaison between managed care organizations and the
facility's professional clinical staff.
Conduct reviews in accordance with certification requirements of
insurance plans or other managed care organizations (MCOs) and
coordinate the flow of communication concerning reimbursement
Inform clinical and medical staff of any specific concerns that
would extend or restrict the length of stay of patients.
Keep accurate record of all contact with external organizations
and persons who have legitimate interest and legal access to
information on the care of patients.
Facilitate peer review calls between facility and external
Act in coordination with the leadership team of the facility or
corporate office to improve the quality of services provided within
Assist the admissions department with pre-certifications of
Initiate and complete the formal appeal process for denied
admissions or continued stay.
Provide ongoing support and training for staff on documentation
or charting requirements, continued stay criteria and medical
Gather and develop statistical and narrative information to
report on utilization, non-certified days (including identified
causes and appeal information), discharges and quality of services,
as required by the facility leadership or corporate office.
Keywords: Camp Recovery, Valdosta , Greenleaf Center Utilization Review Specialist, Other , Valdosta, Georgia
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