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Utilization & Reimbursement Specialist

highlands, ma • Posted 1 weeks ago
Onsite Full Time Bio & Pharmacology & Health

Harboroaks is seeking a healthcare utilization management professional to proactively monitor service utilization and optimize reimbursement for the facility. You will serve as the liaison between managed care organizations and the facility's clinical staff, conduct reviews for certification requirements, and report on utilization and quality of services to leadership.

The role requires knowledge of medical necessity policies, the ability to coordinate pre-certifications, and ongoing staff

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