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    Utilization Review Specialist - Metairie, United States - GulfSouth Autism Center

    GulfSouth Autism Center
    GulfSouth Autism Center Metairie, United States

    1 week ago

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    Description

    Job Description

    Job Description

    GulfSouth Autism Center provides individual treatment plans for children ranging in ages from toddler to preschool that are diagnosed with autism spectrum disorder. Our on-site BCBAs provide individual and group ABA Therapy and our Allied Health team focuses on Speech Therapy as well as Occupational Therapy. GulfSouth therapy is primarily 1:1 teaching children skills such as social interactions, language communication and social development.

    The Utilization Review Specialist Oversees:

    • Oversee daily Operations and the work of GSAC administrative employees.
    • Maintains quality control among all GSAC administrative employees.
    • Is part of annual strategic planning.
    • Manages Autism Center Waitlists, timelines, and clinical operations.
    • Monitor client discharges and outcomes

    Financial

    • Monitor billing vs income for Allied Health
    • Monitors billing vs income for all GSAC locations/providers.
    • Works closely with collections department and assists with billing and collections, when needed.
    • Oversight of Billing Compliance System.

    Compliance

    • Assisting Operations Team with analyzing and updating existing compliance policies and related documentation.
    • Communicating compliance policies and guidelines to Management and designated departments.
    • Developing and executing new compliance policies and procedures as required.
    • Performing Daily internal auditing and compliance checks with our clinics using Catalyst System.
    • Developing and maintaining a compliance recordkeeping system.
    • Assisting with the training of employees on industry compliance requirements.
    • Keeping up with compliance requirements and amendments to regulations.

    Requirements:

    • Bachelor's degree in business administration or accounting preferred
    • In-depth knowledge of industry compliance requirements and standards.
    • Experience with Microsoft Office
    • Exceptional ability to formulate compliance policies, procedures, and related documentation.
    • Advanced analytical abilities.
    • Effective research and professional networking skills.
    • Ability to effectively train employees.
    • Strong leadership and communication skills
    • Exceptional communication and interpersonal skills.
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