Utilization Review Specialist

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.