Spectrum Billing Solutions · 2 months ago
ABA Utilization Review (UR) Specialist
United States
Full-time
Hybrid
Mid Level
3+ years expSpectrum Billing Solutions offers industry-leading revenue cycle management services for healthcare providers. They are seeking an ABA Utilization Review (UR) Specialist to review clinical information and obtain authorizations for ABA and related services. The role requires collaboration with clinical staff and managing authorization processes efficiently.
BillingFinanceFinancial Services
Responsibilities
Review patient admission and clinical information to ensure medical necessity and compliance of utilization review guidelines
Obtain initial and continuing authorization for treatment services
Manage authorization denials including referral for peer review
Document and record all necessary information
Monitor and track new and ongoing authorization cases
Collaborate and communicate with clinical staff to ensure necessary information is obtained and timely reviews are performed
Assist external clients in understanding payer requirements for authorizations
Participate in team meetings
Maintain confidentiality of patient information and adhere to HIPAA regulations
Qualification
Required
3-5 years of related ABA and/or Behavioral Health experience
Superior written and oral communication skills
Attention to detail to ensure necessary information is captured and properly documented
Ability to work independently and within a team
Ability to multi-task, prioritize and meet expected deadlines
Solid understanding of insurance benefits and coverages
Strong computer skills (Word, Excel, billing software)
Understanding of mental and behavioral health treatment services
Preferred
Bachelor's or master's degree preferred
Benefits
Benefits – Medical, Dental, Vision
Flexible Paid Time Off
401K with Company match
Supplemental Benefits
Company
Spectrum Billing Solutions
Spectrum Billing Solutions provides revenue cycle management services to healthcare providers.
51-200 employees
Funding
Current Stage
Growth StageCompany data provided by crunchbase