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Title

CSS Utilization Review Specialist. 

About the Organization Catholic Charities, Diocese of Trenton is a faith inspired non-profit organization, mission-driven, family-friendly, and passionate about services to our communities. We offer a wide variety of exciting career opportunities in the areas of Direct Care, Clinical, Fundraising, Human Resources, IT, Finance, Marketing, and Nursing. When you join us, you can expect a true focus on work-life balance, competitive salaries, comprehensive benefit programs, and an environment that promotes inclusion. Some of our benefits include: generous paid Holidays, Vacation, and Sick time; excellent health & pension plans; and wide array of training and staff development opportunities to earn on-site CEUs. Catholic Charities is an Affirmative Action / Equal Opportunity Employer, fostering a diverse and inclusive environment for staff as well as for people seeking assistance. To learn more about the agency, please visit our website at: www.catholiccharitiestrenton.org.



This position may be subject to Executive Order 283, requiring a proof of being up-to-date with COVID-19 vaccination, including any recommended booster. Requests for reasonable accommodation based on medical condition, disability, or sincerely-held religious belief precluding vaccination will be considered and should be made to Human Resources: 609-394-5181.



 
Req Number DIR-22-00091  
Location BHS - Steinert Ave. (Hamilton, NJ)  
Full-Time/Part-Time Full-Time  
Number of Openings 1  
Category Direct Care - Professionals / Paraprofessionals  
Description

JOB SUMMARY: Responsible for tracking and monitoring timeliness of Progress Notes, Individualized Rehabilitation Plans, clinical assessments inclusive of nursing assessments, intake documents, and all other state required forms. Monitor and track submissions of documents to the Interim Management Entity. Work involves a wide variety of involved clerical operations, requiring the

interpretation of broad guidelines.

 

ESSENTIAL FUNCTIONS:

1. Run Anasazi reports including Suspense, Client Services Listing, Scheduled Services, Non-Final

Approved Progress Notes Report.

2. Compiles reports; updates, checks and completes records, forms and documents

3. Problem solve suspense/billing issues with Utilization Review Manager

4. Verify consumer insurance through the eMevs system.

5. Regular contact with IME to verify status of IRP's. Record and track status of all IRP's.

6. Responsible for maintaining electronic and paper charts which includes required documentation of

service agreements, complaints and grievances, consumer rights, IRPs and nursing assessments

7. Develop forms to track status of projects.

8. Prepares and submits billings as needed

9. Collaborate with Utilization Review Manager and Director of Training and Standards Compliance to

perform non-clinical chart audits to ensure they meet standards and deadlines.

10. Performs moderate level administrative functions

11. Assists with statistical reporting and facilities management as needed

12. Establishes, maintains and updates the filing system

13. Processes and distributes confidential and sensitive documents

14. Performs other general clerical duties (typing, filing, distributing mail, etc.)

15. Operates and maintains a variety of office equipment

16. Other duties as assigned by Utilization Review Manager and Director of Residential Services and

BHS Agency Leadership.

 

KNOWLEDGE/SKILLS/ABILITIES: Ability to multi-task and handle various responsibilities/duties/issues simultaneously while meeting timelines. Detail and problem solving oriented, possess strong organizational skills, excellent interpersonal, written and verbal communication skills, the ability to establish positive interpersonal relationships with staff and colleagues, as well as external community for networking and partnership building.

 

SUPERVISORY REQUIREMENTS: N/A

 
Position Requirements

MINIMUM QUALIFICATIONS: A Bachelor’s degree from an accredited college or university preferred; OR a combination of one or more years of college and work experience equaling four years; Or a High School Diploma with four years work experience.

 

 

LICENSES/CERTIFICATIONS NEEDED: Valid Driver's License

~cb

 
Exempt/Non-Exempt Exempt  
Weekly Work Hours 40  
Schedule Monday-Friday 8:30am- 4:30pm 

This position is currently accepting applications.

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