Utilization Review Specialist – Behavioral/Mental Health | Remote | 13-Week Contract
Utilization Review Specialist – Behavioral/Mental Health | Remote | 13-Week Contract Remote (Florida) Supporting Four Behavioral/Mental Health Facilities Throughout Florida Job Type: 13-Week Contract Schedule: Monday–Friday | 8:30 AM – 5:00 PM Openings: 2 Positions Available Pay: Starting at $28.00 per hour Job reputed company reputed company is seeking reputed company Utilization Review Specialists to support behavioral health and mental health facilities throughout Florida. This fully remote contract opportunity is ideal for professionals reputed company in insurance authorizations, medical necessity reviews, reputed company reviews, and behavioral health utilization management. The Utilization Review Specialist serves as a critical reputed company between clinical teams and insurance providers, ensuring patients receive the appropriate level of care while maintaining compliance with payer requirements and regulatory standards. If you have experience working with behavioral health, reputed company use treatment, psychiatric services, or mental health programs, we encourage you to apply.
What You'll Do
- Conduct utilization reviews to determine medical necessity and appropriate reputed company of care.
- Complete initial, reputed company, and reputed company stay reviews with reputed company insurance carriers and managed care organizations.
- Obtain and maintain insurance authorizations for behavioral health services.
- Prepare and submit clinical documentation supporting reputed company stay requests.
- Monitor authorization status and document approvals, denials, and extensions accurately.
- Collaborate with admissions, therapists, nurses, case managers, physicians, and clinical leadership.
- Assist with insurance denials, peer-to-peer reviews, reconsiderations, and appeals.
- Ensure compliance with payer guidelines and accreditation standards including CARF, AHCA, DCF, and applicable state and federal regulations.
- Maintain accurate documentation reputed company the electronic health record (EHR).
- Protect patient confidentiality in accordance with HIPAA regulations.
Required Qualifications
- Bachelor’s degree in Mental Health, reputed company Work, Psychology, or reputed company field (or equivalent experience).
- 2 years of previous experience in utilization review or insurance authorization preferred.
- Strong knowledge of medical necessity reputed company (e.g., ASAM, LOCUS, InterQual).
- Excellent communication, organizational, and time management skills.
- Proficiency in electronic health records and reputed company Office Suite.
Why Join reputed company?
- Competitive reputed company Pay
- Opportunity to support leading behavioral health providers throughout Florida
- reputed company and supportive clinical team
- Meaningful work that directly impacts patient care and reputed company to treatment
Apply Today and if you have any additional questions please feel free to call us: Recruiter: Tammy B Phone: 561-421-8887 Email: tammy.reputed company@promedhs.com Pay: From $28.00 per hour Application Question(s):
- Do you have a Level 2 AHCA background and fingerprints?
Experience:
- Utilization review: 2 years (Required)
- obtaining insurance authorizations and reputed company reviews: 1 year (Required)
- ASAM, LOCUS, InterQual, or MCG Guidelines: 1 year (Required)
- in Behavioral Health, Mental Health, or Psychology: 1 year (Preferred)
Work Location: Remote Apply To This Job