Job description

JOB TITLE: Behavioral Health Peer Reviewer
REPORTS TO: President & CEO
DEPARTMENT: Peer Review Committee
FLSA STATUS: Hourly – Non Exempt

Summary Description
Reviews patient information to ensure treatment/service provided falls within the plan guidelines and that the service was appropriate for the condition. Reviewing for positions – Psychiatrist, Licensed Therapist, Behavioral Health Physician Assistant.
Specific Responsibilities include, but are not limited to:

• Reviewing x-rays, patient charts and other patient records to ensure treatment/service provided is within guidelines of the plan.
• Review pre-authorization paperwork to ensure the intended treatment meets the treatment plan criteria and relevant program criteria.
• Complete Peer Review Form for each chart reviewed

The list of responsibilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary, if needed.
Academic and Experience Requirements

• Graduation from an accredited school
• Valid, unexpired license to practice in Michigan
• Successful completion /passing of background check, drug screen and credential check

Other Qualifications Desired:

• Ability to communicate effectively (verbal and written).
• Excellent organization and interpersonal skills required.
• Skilled in working with others in a team environment.
• Must be proficient in MS Office applications (Word, Excel, PowerPoint)
• Experience working with EMR systems- eCW preferred. Will train.

Experience

• Minimum 3-5 years of experience as a Psychiatrist, Therapist or other similar related experience.
• Knowledge of Behavioral Health procedures, terminology, and codes.

Job Type: Full-time

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