Insurance Utilization Specialist

The Utilization Specialist works closely with the CRA Integrative Recovery Team by providing support with family communication and acts as a liaison between the organization, insurance, and families/residents. They initiate the first communication with families regarding insurance changes, oversee coordination for every resident’s care and act as a lead to the Care Coordinators in fulfilling their role. The Utilization Specialist also coordinates the Cooper Riis Spravato treatment for residents.

Asheville, NC

Monday – Friday 8-5 pm

• PTO/Sick Time accrual from first day
• Medical/Dental/Vision Benefits
• Company funded-life insurance
• Retirement plan with company match
• Free meals on shift

Starting at $21.50 per hour and increases based on experience

• Calls families within 24 hours of admission, alerts them of denials and/or insurance changes, and provides a bridge to the finance department if there are additional questions
• Coordinates with Care Coordinator and therapist to alert residents of insurance status changes and supports communication with the finance department as needed
• Coordinate the Spravato program, working with prescriber and nursing team to complete VOB, prior authorization, scheduling, and guiding residents through the session.
• Completes all related documentation
• Oversees the care coordination, and guides the care coordinator team on discharge planning and implementation
• Works closely with the team and residents promoting movement through the program and addressing logistical barriers to discharge planning
• In collaboration with the Recovery Team, develops, maintains, and is knowledgeable on a library of resources for referral purposes
• Attends weekly scheduled meetings

• Preferred Master’s Degree in psychology, social work, or other related field
• Experience working with adults recovering from significant mental health challenges and preferably in a residential mental health or substance use recovery setting
• Working knowledge of insurance utilization and ability to collaborate with the finance department on supporting families and residents with their insurance questions and concerns
• Cooper Riis is an equal opportunity employer. We value diversity and are committed to creating an inclusive environment for all employees.
• Cooper Riis is a therapeutic healing community located in Asheville, North Carolina. We are a Smoke/Drug/Alcohol Free Facility.