ArborSys Group ยท 1 month ago
Utilization Review Specialist
Helena,MT,US
Full-time
Onsite
New Grad, Entry Level
$23.65/hr - $23.65/hrArborSys Group is dedicated to improving access to mental health services for children and families across Montana. The Utilization Review Specialist will support timely, appropriate patient care by managing utilization review activities and coordinating authorizations.
ConsultingManagement Consulting
Responsibilities
Managing utilization review activities across inpatient, outpatient, and residential services
Coordinates authorizations
Reviews clinical documentation
Ensures medical necessity
Serves as a key liaison between treatment teams, Medicaid, and private insurance payors
Qualification
Required
Bachelor's degree in social work, psychology, nursing, or related field (or equivalent experience)
Strong clinical understanding of mental health and level-of-care criteria
Experienced with Medicaid/private insurance authorizations, pre-auths, and appeals
Highly organized, detail-oriented, and able to manage multiple referrals and deadlines
Excellent written and verbal communication; professional, clear, and collaborative
Calm under pressure, compassionate with youth and families, and maintains a positive demeanor
Proficient in Epic, insurance portals, and standard office software
Preferred
Experience in mental health or crisis intervention
Benefits
Student loan assistant
6% 403b employer paid contribution
Paid medical and vision insurance
Sick leave
Much more
Company
ArborSys Group
ArborSys is a business consulting and technology integration services firm that provides business solutions and business values.
Founded in 2004
51-200 employees
Funding
Current Stage
Growth StageLeadership Team
Shailesh Shah
Partner; Solution Architect
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