Penrod Enterprises Hiring for Utilization Review Specialist at Remote Full Time

We are looking for a Utilization Review Specialist who can support our busy department. Our ideal candidate has experience working as a nurse or clinican in an inpatient or outpatient behavioral health or substance use disorder facility setting and can provide excellent customer service to facilities while conducting utilization reviews of insurance authorizations. We are looking for skilled professionals who are passionate about their work, and can help us achieve our goals of providing high-quality patient care.

Responsibilities:

• Facilitate phone calls to insurance companies to request authorizations on behalf of heatlhcare providers
• Complete concurent reviews for continued stays
• Submit electronic authorization requests via fax, email. and insurance portals
• Communicate with facility staff regarding upcoming reviews and approvals
• Identify themes and trends in the medical record work and make recommendations for improvement.
• Ensure that compliance with medical/clinical standards are maintained by the treating clinicians

Job Type: Part-time

Pay: $29.00 – $33.00 per hour

Schedule:

• Monday to Friday

Experience:

• Utilization review: 3 years (Preferred)

Work Location: Remote