Pyramid Healthcare Inc.
Utilization Review Supervisor (Finance)
Technical Competencies:
Provide the company with accurate information to ensure full financial coverage for each client day. Provide the referral source(s) with timely information to ensure good customer focus. Maintain client confidentiality and provide a safe therapeutic treatment. Knowledge of local, state and federal regulations. Knowledge of facility contracts and agreements. Knowledge of medical terminology, appeal and denial process, composition of medical records. Knowledge of data entry (primarily Excel) and mathematics. Knowledge of pre-certification process and ASAM. Possesses excellent verbal and written communication skills. Knowledge of CARF standards, release of information and confidentiality. Knowledge of DSM IV, private care managers and county referral sources. Demonstrates the use of: 10 key calculator, Fax, PC knowledge, Microsoft Office (Excel & Word) and a copier.