Job description
Responsibilities:
Essential Duties:
- Complete pre-certifications for clients admitting to any of Newport Healthcare’s programs.
- Utilize clinical information and knowledge of Medical Necessity insurance case managers, facility staff, and plans of care to rationale and communicate healthcare partners.
- Communicate authorization status to families, Admissions Department, Facility Staff, and other stakeholders as needed.
- Document all activities in a detailed manner in applicable CRM/EMR.
- Prepare and submit Appeal documentation (including rationales) to the appropriate entities as indicated.
- Coordinate, schedule, and complete Peer-to-Peer and Appeal reviews as they relate to the precertification process.
- Responsible for coverage of concurrent reviews or administrative tasks, if needed based on business needs.
- Perform periodic reporting on data surrounding pre-authorizations, if needed based on business needs.
- At least two (2) years of work experience in the behavioral health field required.
- Credential in a behavioral health field preferred.
- Bachelor’s/Master’s in a behavioral health related specialty preferred.
Salary Range for this position based on Education and Experience:
Benefits include:
Medical/Dental/Vision
Company Paid Life Insurance
Volunatary STD/LTD
Flexible Spending Accounts
Newport Healthcare is an Equal Opportunity Employer
Newport Healthcare provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability status, protected veteran status, genetic information, or any other characteristic protected by federal, state, or local laws.
For more information on Equal Opportunity, please click here Equal Employment Opportunity Posters
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