Help ensure patients receive the right behavioral health care while supporting compliance and efficiency.
About Assembly Health
Assembly Health is a healthcare management services organization (MSO) headquartered in Chicago, IL. We provide clinical services and business solutions to long-term care facilities and physician practices nationwide, serving more than 4,000 facilities and 300 practices in over 40 states. Our mission is to help communities and providers perform at the highest level so patient care continually improves.
Schedule
- Full-time, remote position
- Non-exempt role reporting to the Director of Billing
- Standard business hours with flexibility as needed
What You’ll Do
- Evaluate patient medical records to determine the necessity and appropriateness of services
- Analyze utilization data to identify trends and recommend improvements
- Manage utilization review schedules with providers and carriers
- Communicate with behavioral health providers and insurance companies to resolve coverage issues and denials
- Obtain and renew prior authorizations; maximize authorizations from payers across all levels of care
- Collaborate with clinical and administrative staff to ensure compliance with protocols and payer guidelines
- Maintain accurate records of reviews, decisions, and communications
- Prepare and submit reports for management, payers, and regulatory agencies
- Review and appeal denied claims as needed with proper clinical documentation
- Participate in UR meetings and execute additional assigned duties
What You Need
- Minimum 1 year of experience in utilization review
- Background in healthcare or behavioral health (mental health, substance use disorder, or psychiatric nursing preferred)
- Familiarity with inpatient and outpatient levels of care (MH and SUD)
- Knowledge of standard medical necessity criteria
- Experience using billing and EMR/EHR software
- Strong Microsoft Office, Google Suite, and Adobe Acrobat skills
- Exceptional organizational skills, attention to detail, and ability to manage multiple priorities
- Excellent communication skills and adherence to confidentiality standards
- Ability to thrive in a fast-paced, sometimes stressful environment
Benefits
- Competitive salary based on skills, experience, and qualifications
- Opportunity to participate in company bonus programs
- Comprehensive benefits package including medical, dental, and vision insurance
- 401(k) plan with employer match
- Paid holidays and paid time off
- Ongoing training, career development, and growth opportunities
Join Assembly Health and play a critical role in ensuring patients receive quality, compliant care while advancing your career in behavioral health.
Happy Hunting,
~Two Chicks…