In this role, you will:
Act as liaison between managed care organizations and the facility’s professional clinical staff.
Conduct reviews in accordance with certification requirements of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements.
Inform clinical and medical staff of any specific concerns that would extend or restrict the length of stay of patients.
Keep accurate record of all contact with external organizations and persons who have legitimate interest and legal access to information on the care of patients.
Facilitate peer review calls between facility and external organizations.
Act in coordination with the leadership team of the facility or corporate office to improve the quality of services provided within the organization.
Assist the admissions department with pre-certifications of care.
Initiate and complete the formal appeal process for denied admissions or continued stay.
Provide ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates.
Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office.
And more!
Headquartered in Franklin, Tennessee, Acadia Healthcare was established in January 2005 to develop and operate a network of behavioral health facilities across the country.
Acadia Healthcare’s mission is to create a world-class organization that sets the standard of excellence in the treatment of specialty behavioral health and addiction disorders.
Acadia’s management style and philosophy is one of collaboration and flexibility as we create an energetic and team-oriented service delivery system. Our organization values input from employees, physicians, and all strategic alliances. As evidenced in our mission statement, Acadia Healthcare’s mission is to create behavioral health centers where people receive care that enables them to regain hope in a supportive, caring environment. We want Acadia to be synonymous with excellent care, phenomenal customer service and an unparalleled commitment to our patients, staff, physicians, and community.
As a leading provider of behavioral healthcare services in the United States and Puerto Rico, Acadia Healthcare operates 253 treatment facilities across 39 states. Our network of treatment facilities offers multiple levels of care for various behavioral health and substance use disorders. At Acadia, our primary goal is to meet patients where they’re at in their treatment process. We do this by providing a multitude of levels of care, including detoxification, residential treatment for addiction, residential treatment for dual diagnosis, acute psychiatric inpatient hospitalization, medication-assisted treatment (MAT) services, and an array of outpatient programming options, ranging from partial hospitalization programs (PHPs) and intensive outpatient programs (IOPs) to traditional outpatient services. Our network of treatment facilities creates greater access to care, reduces the stigma associated with mental illness and addiction, and offers those in our communities a safe environment in which to receive the treatment they need.
