The Utilization Review and Intake Specialist is PRN (4-8 shifts per month) and you must have availability to work Monday-Friday, day shift.

The Utilization Review and Intake Specialist assists patients and families access treatment by providing information, conducting pre-admission screenings/assessments, and coordinating admissions to the clinic.  They obtain insurance information on behalf of prospective patients and work with the clinical team to advocate for coverage by presenting current symptoms, interventions, the treatment plan, and estimated length of stay information to the patient’s insurance/managed care company. If needed, the utilization review and intake specialist will coordinate physician reviews, and in cases of insurance denials, will communicate financial implications to patients/families as well as initiate the appeals process on behalf of the patient/family. The specialist advocates on behalf of the patient to overcome barriers to treatment.

EDUCATION/TRAINING REQUIREMENTS:

1. Bachelor’s Degree in Behavioral Sciences, Criminal Justice, or related field.
2. Two (2) years of healthcare setting/psychiatric clinic and/or insurance experience is required.
3. Experience and comfort working autonomously and independently is required.
4. Use of insurance UR or Case Management software or experience with electronic health record system is preferred. Cerner® experience is a plus.
5. Knowledge of medical terminology and psychiatric clinical criteria is preferred.
6. Extensive knowledge of managed care, Medicare, and Medicaid.
7. Knowledge of DSM, medical, mental health, and chemical dependency diagnosis and treatment process.
8. Computer skills are required, including word processing, spreadsheets, and data processing.
9. Knowledge of Joint Commission documentation and medical records standards and the ability to maintain accurate records.

ABOUT ROGERS BEHAVIORAL HEALTH

Based in Wisconsin since 1907, Rogers Behavioral Health is a private, not-for-profit provider of behavioral health services and is nationally recognized for its specialized psychiatry and addiction services. Anchored by the main campus in Oconomowoc, WI, Rogers offers evidence-based treatment for adults, children, and adolescents with depression and other mood disorders, eating disorders, addiction, obsessive-compulsive and anxiety disorders, and Trauma (PTSD).

Rogers provides residential care and has three inpatient facilities that serve southeastern Wisconsin. Rogers also offers outpatient services throughout the state of Wisconsin as well as in California, Florida, Illinois, Minnesota, Pennsylvania, and Tennessee.

The System also includes Rogers Behavioral Health Foundation, which supports patient care, programs, and research; and Rogers InHealth, an initiative that works to eliminate the stigma of mental health challenges. For more information, visit www.rogersbh.org.

Required Skills Required Experience

REQUIRED SKILLS:

• Bachelor’s degree with major in Accounting.
• Five to seven years’ experience in Finance/Accounting, CPA preferred but not required.
• Proven ability to mentor, motivate and grow team members.
• Experience managing multiple activities, prioritization of tasks and problem resolution.
• Strong written and oral communications skills.
• Financial Planning and Analysis experience a plus.
• Proficient knowledge of MS Office, including Word, Excel and PowerPoint.
• Knowledge of Epicor and Cognos TM1 a plus.