Job Title: Utilization & Revenue Cycle Coordinator

Location: Naples, Florida

Company: David Lawrence Centers For Behavioral Health

Job Type: Full-Time & Hourly/Non-Exempt
~ Monday-Thursday, 830AM-5PM
~ Friday, 830AM-3PM

Salary: Starting at $23.00 per hour
~ Additional Consideration for experience and/or Spanish Bilingual

Hiring Incentives: PTO W/In 90 days, Full Benefits W/401k, Professional Development & Tuition Programs.

Job Summary: The Utilization & Revenue Cycle Coordinator plays a key role in supporting the financial health and operational efficiency of DLC. This position is responsible for monitoring service utilization, ensuring accurate documentation and billing practices, and coordinating efforts across clinical and administrative teams to support timely reimbursement and revenue integrity.

Key Responsibilities:

- Obtain subsequent authorizations of clinical services from insurance companies as defined by DLC.

- Review medical records and determine appropriateness of patient level of care, continued length of stay and discharge.

- Communicate with providers to support timely submission of utilization reviews or continued stay requests.

- Maintain accurate records of service authorizations and utilization patterns for audit and reporting purposes.

- Monitor and track service utilization against authorizations, treatment plans, and payer limits.

- Collaborate with revenue cycle team to ensure accurate charge capture and claims submission.

- Perform follow-ups on unpaid or denied claims, initiating appeals when necessary.

- Implement strategies to reduce claim denials and underpayments through root cause analysis and process improvements.

- Stay up-to-date with payer policies, regulations, and industry best practices related to utilization and billing.

- Demonstrates knowledge of, and supports, standards, policies and procedures, operating instructions, confidentiality standards, and the code of ethical behavior.

- Other duties as assigned by the Director of Revenue Cycle Management.

Qualifications:

- High School Diploma or GED = Required

- 2+ years of UM, billing and collections experience in a health-related field = Required

- Familiarity with health insurance, managed care organizations, third party payer and ASAM level of care criteria = Required

- Knowledge of and ability to adhere to HIPPA regulations = Required

- Ability to work independently as well as relate to a diverse group of Clients/Colleagues = Required

- Strong capabilities in task prioritization, problem solving and proper management of time/information = Required

- Efficient and effective communication skills as part of a Team = Required

- Microsoft Office 365 skills (Including Teams/Video Conferencing) and Electronic Medical Records experience = Strongly Preferred

- Staying compliant on all trainings and immunizations = Required

- Ability to pass Level II DCF Mental Health Fingerprinting, Drug Screen and Local Criminal Check = Required

Physical Requirements: This position requires a mix of physical activities throughout the workday. Duties involve periods of standing, sitting, and walking, often across various areas of the site. The role also includes tasks that may require bending, reaching, and other physical movements. Candidates must be able to occasionally lift and carry items weighing up to 50 pounds. A reasonable level of physical stamina and mobility is necessary to successfully perform the essential functions of this role.