Utilization Review Specialist

Weekly outpatient therapy isn't always enough, and a trip to the ER isn't the only answer. Patients and their families rely on Compass Health Center when in crisis – every day, we help people overcome depression, anxiety, suicidality, obsessions/compulsions, trauma, chronic pain, and other obstacles in order for our patients to live freely. About This Role We are seeking a REMOTE Utilization Review Specialist to obtain appropriate insurance authorization for our patients to receive Behavioral Health treatment at high levels of care. The UR Specialist will act as the liaison between the clinical team and the insurance company, facilitating and maintaining insurance approval through a patient’s treatment at Compass Health Center . This person will advocate on behalf of the patient to overcome financial barriers to treatment. Our dedicated operations teams work behind the scenes to bring our shared mission to life. Each department delivers their own set of strengths which empower our clinicians to focus on their expertise, and ultimately perform the meaningful work that we do. What You'll Do: Contacting Insurance companies to verify insurance coverage and obtaining approval of treatment as recommended by the clinical team. Collaborating with the clinical team to compile treatment plans and supporting clinical documentation. Working with all internal departments as necessary, such as Revenue Cycle and Patient Advocates. Accurately documenting Electronic Medical Records to reflect approval or denial of treatment authorization. Communicating insurance authorizations/denials and insurance needs to appropriate internal staff. Scheduling and delivering concurrent authorization reviews as required by individual insurance companies. Coordinating physicians’ reviews and appeals. Who You Are: Bachelor’s Degree (preferred) or relevant experience Previous healthcare or insurance experience Knowledge of medical terminology and psychiatric criteria Have the ability to analyze and co