Job Detail

Our mission at Interface Billing Solutions is to empower healthcare organizations through the art and science of Revenue Cycle Management. We believe in a future where financial stability and patient care excellence coexist seamlessly. With unwavering dedication, innovative solutions, and a relentless commitment to integrity, we inspire our clients and employees to thrive, driving positive change in the healthcare industry. Together, we reimagine possibilities, ensuring that every patient's journey is met with financial clarity, and every organization's vision becomes a reality.

Job Summary:

We are seeking an experienced, dedicated, and passionate Utilization Review Specialist with a LMFT (Licensed Marriage and Family Therapist), LCSW (Licensed Clinical Social Worker), LAADC (Licensed Advanced Alcohol Drug Counselor), LMHC (Licensed Mental Health Counselor), or LPC (Licensed Professional Counselor) license to service our clients in the mental health and chemical dependency rehabilitation industry. This is an excellent opportunity for someone looking to further their career in healthcare and revenue cycle management with a focus on these specialized areas. This role requires a proactive and results-driven individual with a learner’s mindset who can work strategically and collaboratively with both client and internal teams to achieve maximum authorization for patients’ treatment services.

Responsibilities:

• Conduct comprehensive utilization reviews of patient records, ensuring adherence to clinical protocols and regulatory requirements.
• Collaborate closely with clinical staff and treatment teams to gather necessary information for utilization review purposes.
• Evaluate treatment plans and interventions to determine appropriateness, effectiveness, and compliance with insurance and regulatory standards.
• Provide expertise in clinical documentation and treatment modalities to support the authorization of services.
• Communicate with insurance companies to advocate patient treatment authorizations.
• Facilitate peer to peer review sessions to represent a patient’s medical necessity for treatment.
• Stay abreast of industry trends, regulations, and best practices related to utilization review in mental health and chemical dependency treatment settings.

Qualifications:

• Master's degree in Counseling, Psychology, Social Work, or related field.
• LMFT / LCSW / LAADC / LMHC / LPC license in good standing with relevant state licensing board.
• Minimum of 5 years of experience in utilization review within the mental health and chemical dependency field.
• Strong knowledge of insurance guidelines, managed care principles, and accreditation standards.
• Results-oriented with a focus on meeting deadlines.
• Ability to work independently and collaboratively in a team-oriented environment.
• Proficient in working in a digital environment and using multiple software for productivity, communication, and documentation.
• Excellent organizational and time-management skills.
• Works with a sense of duty – values strong attention to detail.
• Works with a sense of urgency and prioritizes time-sensitive deadlines.
• Ability to multitask, prioritize, and remain organized.
• Excellent analytical, communication, and problem-solving skills.
• Ability to work in a fast-paced environment and willingness to learn and adapt.

What We Offer:

• Competitive pay and performance-based incentives with accelerated opportunities for growth based on meritocracy with less focus on seniority.
• Comprehensive benefits package, including health/dental/vision insurances, and 401(K).
• Ongoing professional development opportunities.
• A positive and collaborative work environment focused on making a difference.

Job Type: Full-time

Pay: $65,000.00 - $75,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Work Location: In person