Sign on bonus
- 1 or more years of experience - $2,500
- Less than 1 year of experience - $1,000
To provide consultant capacity within the multidisciplinary care team, facilitating psychosocial screening, collaborating with care teams to manage patients psychosocial and behavioral health issues. Utilize Milliman/Interqual/Midas to assist with establishing clinical criteria for admission, treatment, and discharge.
- Utilize Milliman (Interqual) criteria to assist with establishing clinical criteria for admission, to monitor clinical progression, to evaluate criteria for continued stay, and to establish an anticipated discharge date
- Contact insurance companies and provides required information to obtain Medicaid or insurance authorization for admission, complete continued stay reviews, or obtain authorization for services
- Records required information to track pertinent patient information, IE: MIDAS, Meditech, Epic, and appropriate referral software programs
- Performs preauthorization related to admission needs
- Assists with denial notifications and the appeal process
- Works with hospital case management to assist with challenges related to discharge to assure the best outcome for patients
- Initial authorizations for Addiction Recovery In Patients, Intensive Out Patients, Partial Hospitalization Patients, and Continuing Care Patients
- Initial authorizations for Mental Health In Patients
- Concurrent reviews
- Discharge reviews
- Functions as class facilitator as needed.
- Proficiency with Word, Excel, and Power Point is an added benefit.