Admissions & Utilization Review Specialist

Company : MVP Recovery

Location : system wide

About Us :

MVP Recovery is a leading behavioral health company dedicated to providing comprehensive care and support to individuals seeking recovery from substance use and mental health disorders.

We offer a compassionate and holistic approach to treatment, focusing on personalized care and long-term success for our clients.

Job Description :

As Admissions & Utilization Review Specialist at MVP Recovery, you will play a crucial role in ensuring the financial health of our organization while supporting our mission to provide exceptional care to our clients.

You will be responsible for accurately and efficiently processing medical claims, verifying insurance coverage, and resolving billing issues.

Additionally, you will collaborate closely with our clinical and administrative teams to optimize revenue cycle management and maintain compliance with regulatory requirements.

Responsibilities :

• Review claims to insurance companies and government payers
• Verify insurance eligibility and benefits for patients
• Follow up on outstanding claims and denials to ensure timely payment
• Resolve billing discrepancies and address patient inquiries regarding billing issues
• Collaborate with clinical and administrative staff to ensure accurate documentation and coding
• Stay up-to-date on billing regulations and compliance requirement
• Navigation of co-pays for commercial insurances
• Obtaining Non par agreements
• Utilization Review
• Obtaining authorizations from payer sources

Qualifications :

• Proven experience as a medical billing specialist, preferably in behavioral health or healthcare setting
• Strong knowledge of medical billing procedures and coding (CPT, ICD-10)
• Familiarity with insurance guidelines and reimbursement processes
• Excellent attention to detail and accuracy
• Effective communication and problem-solving skills
• Ability to work independently and as part of a team
• Proficiency in medical billing software and Microsoft Office suite

Benefits :

• Competitive salary commensurate with experience
• Comprehensive benefits package including health, dental, and vision insurance, tuition reimbursement, retirement plan
• Paid time off and holidays
• Opportunities for professional development and advancement
• Supportive and collaborative work environment dedicated to making a positive impact on the lives of others

How to Apply :

If you are passionate about making a difference in the lives of individuals struggling with substance abuse and mental health disorders and possess the skills and experience to excel in this role, we encourage you to apply.

Please submit your resume and cover letter detailing your qualifications and why you are interested in joining the MVP Recovery team.

We look forward to hearing from you!