The Utilization Review Clerk assesses the needs of the UR department in collaboration with the UR Manager or Director. The clerk assists in faxing reviews to managed care companies, assists the UR Manager or Director with all data reporting as directed, and assists in scheduling and following up on all peer-to-peer reviews. The clerk monitors all pre-authorizations conducted by the assessment department for admissions to inpatient and outpatient treatment, ensuring pre-authorization was obtained and entered into the patient database. The clerk scans documentation into the patient database and ensures that all Medicare certification letters are signed by the appropriate provider.
Qualifications
Education: High School Diploma/GED required. Bachelor's degree preferred.
Experience: Previous experience in a psychiatric health care facility or experience in office support and organization preferred.
License: Valid driver's license
Additional Requirements: CPR certification and Crisis Prevention Training (CPI) within 30 days. May be required to work flexible hours and overtime.
JOB RESPONSIBILITIES
Provides clerical support to the UR Manager or Director and UR Team. Enters information and scans documentation into the patient database system accurately.
Maintains appropriate stock of paperwork/forms and supplies to support the UR Department.
Checks on authorization status with the assessment department.
Assists other units and departments, as needed.
Sends appropriate documentation to managed care companies in the appropriate timeframe.
Provides assistance with discharges. Calling in and faxing in discharge clinical information.
Enters information accurately on the UR spreadsheet.
Assists in scheduling and following up on peer to peer reviews.
Assists the UR Manager or Director with all data reporting as directed.
Ensures all Medicare cert letters are signed by the appropriate provider
Assists in filing and maintaining the organization and accuracy of the filing system.

PHYSICAL, MENTAL, AND SPECIAL DEMANDS
1. Ability to sit and stand (at least two-thirds of the shift) and walk (possibly one-third of the shift).
2. Ability to reach above, or below waist height, kneel, bend, stoop, turn, and twist (occasionally to frequently).
3. Visual ability to read charts, treatment plans, financial documents, computer screen and typewritten materials.
4. Ability to frequently push/pull wheeled carts to 100 pounds.
5. Ability to frequently lift and carry 10 lbs.; occasionally 20 to 50 lbs.
6. Ability to work in an environment where chemicals are frequently used for cleaning, where medical and electrical hazards may be present and where dust, mist and steam are frequently generated in housekeeping tasks.
7. Ability to work at a rapid pace and perform a variety of repetitive duties.

Lifepoint Health is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.