Pyramid Healthcare is dedicated to offering the highest quality of care to those we serve. A focus on client-focused care establishes our family of brands as respected leaders in addiction treatment, mental health recovery and eating disorder treatment modalities.

Pyramid Healthcare offers comprehensive behavioral healthcare defined by supportive environments that offer patients the strength they need to overcome life’s challenges. We offer behavioral healthcare services – psychiatry, addiction recovery, mental disorder treatment, etc. – that allow clients at all stages of recovery or rehabilitation to reclaim health and well-being.

Summary: The Utilization Review Assistant provides administrative and operational support to the Utilization Review team to ensure timely and accurate completion of authorizations and documentation. This role assists with communication between funders, providers, and internal departments to maintain program efficiency and compliance.

Essential Duties And Responsibilities

Track and monitor all client admissions to ensure timely completion of documentation and authorization follow-up.
Maintain accurate admission, authorization, and tracking records to ensure compliance and data accuracy.
Verify insurance coverage and eligibility to ensure active funding prior to admission.
Communicate with funding sources to clarify requirements and resolve authorization issues.
Assist with scheduling and coordinating peer-to-peer reviews between providers and funders.
Support Utilization Review staff with ongoing administrative tasks and documentation updates.
Report client discharges to funders as directed, in accordance with program and payer requirements.
Collaborate with internal departments to support communication, workflow, and overall program efficiency.
Must exercise discretion and maintain confidentiality with regard to all company information
Completion of all required trainings as designated by the company and accreditation/licensing entities.
Other duties as assigned.

Supervisory Responsibilities

None

Required Qualifications

Education, Licensure, & Experience

High school diploma or equivalent required
Previous experience in a behavioral health, medical, or administrative support setting preferred

Job Knowledge, Skills, And Abilities

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Excellent oral and written communication and interpersonal skills
Ability to problem solve by gathering and analyzing information
Proficiency with electronic documentation or tracking systems used to manage admissions, authorizations, and client records, as well as standard office software applications.
Ability to work both independently and collaboratively across departments to support efficient workflow
Ability to handle a crisis and or potential risk situation and react appropriately
A working knowledge of federal and state standards as well as regulating body and compliance standards.

Physical Demands

While performing the duties of this job, the employee is frequently required to talk or hear. The employee is regularly required to sit, use hands to finger, handle, or feel, and reach with hands and arms. The employee is occasionally required to climb stairs, stand, walk, stoop, twist, kneel, or crouch. The employee must occasionally lift and/ or move up to 25 pounds. The employee must seldom lift and/or move up to 50 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus.

Work Environment

The noise level in the work environment is usually moderately quiet & indoors. This position will require local travel. This position will be scheduled based on operational need & will be required to provide own transportation. Incumbent may be exposed to virus, disease, and/or infection from clients in the work environment. Incumbent may be exposed to traumatic situations (i.e. psychiatric).

Compensation

This position may be subject to state or local wage transparency requirements. Where required by law, a compensation range will be provided. For candidates applying in jurisdictions with such requirements, the applicable range will be disclosed either in this posting or during the interview process. Please note that compensation may vary depending on factors such as geographic location, experience, qualifications, and internal equity. To inquire about the salary range for your specific location, please contact our recruitment team.

Pyramid CORE Values

We are committed and proud to live our CORE values and use them to inspire those around us. Our employees are expected to align with these values, behaviors, and standards. We are held accountable for upholding these CORE Values: INTEGRITY is striving to be honest, transparent, and ethical when dealing with clients, staff, and the community. DEDICATION is demonstrating an unwavering commitment to always provide exceptional care and support to those we serve is needed daily. COLLABORATION is a steadfast, team-focused approach; working together to achieve excellence. PASSION is genuine, compelling, and relentless desire to improve lives and support Pyramid Healthcare’s mission.

Total Rewards For Full-Time Positions

Medical, Dental, and Vision Insurance
Flexible Spending Accounts
Life Insurance
Paid Time Off
401(k) with Company Match
Tuition Reimbursement
Employee Recognition Programs
Referral Bonus opportunities
And More!

Want to know more?

To learn more about Pyramid Healthcare, and how you can achieve personal and professional growth, visit us at: https://bit.ly/Pyramid-Careers.

Pyramid Healthcare, Inc. is proud of its diverse workforce, and is an Equal Opportunity Employer.

Pyramid Healthcare, Inc.

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