Behavioral Health Billing Specialist Jobs in Pennsylvania

Knowledge of utilization review processes and utilization management systems, moderate to strong knowledge of InterQual required.

Assures that clinical staff are documenting appropriately in medical management system so that member letters are clear and understandable.

Familiar with all aspects of operations in the Utilization Management Department.

Strong problem-solving abilities, organizational and planning skills.

Selects specific transactions and processes to be reviewed for compliance audits on a monthly basis and reports findings to Manager/supervisors.

Assists the director/ manager in identifying training needs and assists in departmental training and the onboarding of new hires.

Facilitate support groups e.g. chronic disease-self management, pain management, smoking cessation.

Develop proficiency in fundamental medical terminology and education as it relates to chronic illness e.g. diabetes, hypertension, COPD/asthma, pain disorders

Help patients, families, and caregivers build skills to improve coping, distress tolerance, and stress reduction.

Teach prevention and techniques to self-manage symptoms and chronic illness.

Develop educational, training materials and conducts sessions or disseminates information to care team on recent advances in the field.

Experience in substance abuse counseling.