Utilization Review Behavioral Health

Introduction

Motivated and detail-oriented professional with a strong background in behavioral health services, specializing in client advocacy, utilization review, and admissions counseling with empathy and compassion. Looking to expand my career with a company I can grow with and utilize my skills and experience. Skilled at navigating complex healthcare systems, securing prior authorizations, and collaborating with multidisciplinary teams to ensure optimal patient care. Proficient in leading industry software platforms and committed to supporting individuals in accessing high-quality treatment.

Work Experience

Zinnia Health – Delray, Beach, FL 10/2024 – 08/2025

Utilization Review

Submit prior authorizations for substance abuse treatment

Knowledgeable of ASAM dimensions and levels of care

Using KIPU, Salesforce, and Bedboard software to manage client tracking and documenting

Advocate for clients’ access to treatment by communicating effectively with care managers

Collaborated with treatment team through Microsoft Teams

experience in patient assessment, medical terminology, and medical records

skills in communication, triage nursing, and medical office management.

Sunrise Detox – Ft. Lauderdale, FL 8/2023 – 10/2024

Admissions Counselor 2/2024-10/2024

Interview and document new admissions biopsychosocial and initial treatment plans

Review all consent forms with clients and get signatures where necessary

Verify insurance benefits and COB, update flash census report while collaborating with UR

Facilitate group therapy

Assist BHT’s with training, rounds and vitals when needed

BHT 08/2023-2/2024

Preformed vitals 3x daily, 30-minute interval rounds

Orientate new clients to facility and give tour

Conduct body and luggage searches and process UDS.

Write and distribute communication emails

Beautiful Vacations – Dania, FL 04/2021 – 7/2023

Customer Service Specialist

Tele-marketing phone sales providing personalized vacation packages to customers

Maintain customer relationships for referral program and continued business

Remain open to feedback from supervisors and peers to build and improve skill set

HVAC Solutions, Inc. – Verplanck, NY 06/2011 – 12/2019

Executive Secretary

Respond to customer inquiries escalating urgent issues according to established protocol

Utilized Quickbooks to prepare invoices, letters, memos and print payroll checks

Manage/maintain executives’ calendars while maintaining the service calendar for the techs

Exhibit strong organizational skills to manage multiple projects simultaneously while obtaining the proper permits and writing proposals for each project

Maintained up-to-date knowledge of company policies and licensing to ensure compliance with applicable regulations

Responsible for the switchboard calls and dispatching to the techs any urgent calls throughout the day

Recruiting and on-boarding new technicians

Community Orthopedics – Cortlandt Manor, NY 08/2007 – 12/2011

Front Office Administration

Greet/check in patients while monitoring the switchboard transferring calls to the correct department

Schedule and confirm appointments for 6 Doctors between 3 office locations

Collected payments and recorded receipts, scheduled follow-ups during the checkout process

Completed prior authorization requests for medication, procedures and referrals

Pulled and prepped charts for upcoming appointments to guarantee all referrals and lab results are up to date while scanning medical records into new EMR maintaining strict confidentiality/HIPPA policies during a company merger

SKILLS

CPR Certification

CPI Certification

Crisis Intervention Strategies

Empathy and Compassion

Communication Skills

Team Collaboration

Organizational Skills

Multi-tasking capabilities

Pay attention to detail

Customer Service

Works well independently and as part of a team

Reliable and Professional

Continuous improvement

Computer savvy and quick learner

oMicrosoft 365, Teams, Word, Excel, Outlook

oKIPU

oSalesforce

oLightning Step

oObservSMART

oGo To Phone and Five9

oQuickbooks

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