Utilization Review Administrative Coordinator

This is a fully remote position, open to applicants in Brazil, +5 more countries.

📋 Description

• Oversee the Authorization email and delegate new intakes to the suitable team member.

• Recognize discharged cases, transitions, and alterations in levels of care.

• Detect insurance or policy modifications that may influence authorization or reimbursement and communicate them appropriately.

• Identify urgent or time-sensitive authorization issues and ensure they are promptly addressed.

• Submit designated CareOregon authorization requests via the payer portal.

• Precisely input authorization details into OpenPM.

• Review information for precision and detect discrepancies, missing documentation, or incomplete data.

• Follow through on assigned tasks until completion and maintain necessary documentation.

• Communicate effectively and professionally with treatment facilities, clinical teams, payers, and internal team members.

• Acquire knowledge of payer requirements, authorization protocols, and behavioral health levels of care.

• Offer additional administrative assistance to the Utilization Review team as needed.

⛳️ Requirements

• Exceptional focus on detail and accuracy.

• Excellent organizational and time-management abilities.

• Strong written and verbal communication skills.

• Proficient problem-solving and critical-thinking capabilities.

• Ability to swiftly learn new systems, payer prerequisites, and processes.

• Demonstrated initiative, accountability, and consistent follow-through.

• Strong sense of ownership, taking full responsibility for assigned tasks and deliverables.

• Sound judgment with the ability to discern when an issue requires escalation.

• Professionalism in interactions with facilities, payers, and internal teams.

• Previous experience in behavioral health, healthcare administration, medical billing, insurance, utilization review, or revenue cycle management is preferred but not mandatory.

• Experience with insurance portals, electronic health records, or practice management systems is preferred but not mandatory.

• Familiarity with behavioral health levels of care such as Detox, RTC, PHP, and IOP is advantageous.

• CareOregon or Medicaid experience is a bonus.

• Experience with OpenPM is a bonus.

• Strong computer and data-entry competencies.

🏝️ Benefits

• Comprehensive health coverage.

• Opportunities for professional development.

• Collaborative work environment.

• Flexible working hours.