Employer Industry: Healthcare Services

Why Consider this Job Opportunity:
- Competitive Salary up to $70,000
- Opportunity for career advancement and growth within the organization
- Work remotely from the comfort of your home
- Comprehensive benefits package including Medical, Dental, and Vision Insurance
- Tuition Reimbursement and Employee Recognition Programs available
- Supportive work environment with a focus on employee well-being

What to Expect (Job Responsibilities):
- Conduct admission, continued stay, and discharge reviews for managed care clients
- Maintain positive relationships with referral sources and insurance companies
- Track admissions, continued stay, and discharge PCPC requirements for county referrals
- Monitor Census for accuracy of funding and work directly with Billing Department to reduce uncovered days of funding
- Attend clinical staffing to obtain information for client reviews and maintain daily UR database accurately

What is Required (Qualifications):
- Must have an Associate's degree
- Experience in Utilization Review or related position in a healthcare setting
- Knowledge of local, state, and federal regulations
- Proficiency in data entry (primarily Excel) and mathematics
- Familiarity with medical terminology, appeal and denial process, composition of medical records

How to Stand Out (Preferred Qualifications):
- Previous experience in Utilization Review
- Knowledge of DSM IV, private care managers, and county referral sources

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