Utilization Review Coordinator

Lighthouse Care Center of Augusta (LCCA) is a multi-discipline behavioral healthcare center that offers mental health services to the communities of surrounding Augusta, Georgia. The Lighthouse Care Center of Augusta is an acute and residential treatment facility providing balanced, top-notch clinical care to children, adolescents and young adults. We provide a carefully-structured and supportive environment, and our education program is accredited through the Georgia Accrediting Commission.

Much more available online at: https://lighthousecarecenters.com/

LCCA is recruiting for a marvelous Utilization Review Coordinator. Under the direction of the UR Manager, the Utilization Review Coordinator will review clinical content of medical records, participate in treatment team meetings, collaborate with physicians, therapist, nurses and pertinent staff on gathering the necessary data to communicate with insurance companies/authorizing entities to ensure initial precertification and continued authorization is achieved. Utilization Review Coordinator will ensure input of pre-certifications and continued stay reviews into Midas, follow-up on unfinished pre-certifications from the day before, coordinate with the treatment team on any follow-ups necessary, verify insurance coverage at the first of the month, and post patient payments into MS4. Under the Manager of Utilization Review, the Utilization Review Coordinator will be trained in all aspects relative to timely gathering clinical criteria, communication of clinical criteria, and entry of supporting clinical criteria into computer based systems, in addition to other job duties.

This opportunity provides the following:

UHS is Challenging and rewarding work environment
Growth and development opportunities within UHS and its subsidiaries
Competitive Compensation
Excellent Medical, Dental, Vision and Prescription Drug Plan.
401k plan with company match
Generous Paid Time Off

EDUCATION AND EXPERIENCE

Masters level education in social science field (social work, counseling, sociology, psychology). Must be license-eligible.

Nurses with a current GA or Multistate RN license encouraged to apply.

Must have 2 years of experience in a psychiatric health care setting, delivery of care to psychiatric and/or chemically dependent patients and utilization review.

CERTIFICATIONS, LICENSES, REGISTRATION

Valid state driver's license with appropriate endorsement. Current Registered Nurses license.