Compass Health Center · 6 hours ago
Utilization Review Specialist
Compass Health Center is a recognized leader in crisis-level mental health, providing patient-centered care in the Behavioral Health space. The Utilization Review Specialist will obtain insurance authorization for patients, act as a liaison between the clinical team and insurance companies, and advocate for patients to overcome financial barriers to treatment.
Health CareMedicalMedical DeviceMental Health
Responsibilities
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
Qualification
Required
Previous healthcare or insurance experience
Knowledge of medical terminology and psychiatric criteria
Have the ability to analyze and communicate clinical information from progress, group and psychiatric chart notes
Have the ability to work autonomously and independently while working collaboratively as part of a team
Have the ability to think critically and make decisions within individual role and responsibility
Possess strong written and verbal skills
Have strong organizational and time management skills with ability to manage workload independently
Have the ability to foster and maintain positive relationships externally and internally
Preferred
Bachelor's Degree (preferred) or relevant experience
Familiarity with Microsoft Office, Outlook, and EMR
Benefits
Comprehensive medical/dental/vision plans
401k program with company matching
Generous PTO (including competitive parental leave after 1 year of employment)
Continuous training through CEU seminars and volunteering opportunities
Company
Compass Health Center
Compass Health Center is the expert in crisis level mental health care for children, adolescents, young adults, and adults.
Funding
Current Stage
Late StageRecent News
BizTimes Milwaukee
2025-08-13
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