Top 16 Utilization review Jobs in Beckley, Wv

Business Office Manager
Fayetteville Healthcare Center —Fayetteville, WV
- Full-time
- Microsoft Excel
- Skilled nursing facility
- Computer literacy
- Health insurance
- Dental insurance
7d
Care Manager
Appalachian Regional Healthcare, Inc. —Beckley, WV
- Full-time
- Nursing
- RN License
- 5 years
4d
Nurse Practitioner (F2F)
MTC Care —Beckley, WV
- From $135,000 a year
- Full-time
- Nursing
- Skilled nursing facility
- Microsoft Outlook
Medical Director of Advisory Services
Sound Physicians —Beckley, WV
- Full-time
- Medicine
- Hospital
- BC/BE
- Health insurance
- 401(k)
Regional Medical Director, Physical Medicine and Rehabilitation (PM&R)
Personalized Health Partners —Beckley, WV
- Full-time
- Medicine
- Skilled nursing facility
- Management
Psychiatric Mental Health Nurse Practitioner (PMHNP) (In-person)
MTC Care —Beckley, WV
- From $145,000 a year
- Full-time
- Nursing
- Skilled nursing facility
- Microsoft Outlook
Appeals Professional III (Licensed Clinician)
Tanaq Support Services LLC —United States
- Full-time
- Remote
- Nursing
- RN License
- Writing skills
11d
Claims Nurse (Utilization Management / Claims Review) Must have CALIFORNIA license
Dragonfly Global —United States
- $100,000 - $105,000 a year
- Full-time
- Remote
- LVN
- RN License
- Mid-level
- Travel reimbursement
- Health savings account
Quick Apply

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Care Manager
Appalachian Regional Healthcare, Inc. —Beckley, WV
Care Management is willing to seek certification in case management field if made available through ARH. Associate's Degree Registered Nurse (licensed in state…
4d
Telephonic Case Manager I
CorVel Corporation —Charleston, WV
URAC recognized Case Management certification (ACM, CCM, CDMS, CMAC, CMC, CRC, CRRN, COHN, COHN-S, RN-BC) required to be obtained within 3 years of hire if no…
$63,739 - $95,264 a year
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Bachelor’s Degree in Social Work, Psychology, or related field, required. Documents all case reviews and maintains accurate records of all clinical activities…
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Business Office Manager

Fayetteville Healthcare Center -
Fayetteville, WV

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Job Details

Full-time
7 days ago

Benefits

Health insurance
Dental insurance
Flexible spending account
Paid time off
Vision insurance
401(k) matching

Qualifications

Staff supervision
Microsoft Excel
Long term care experience
Medicare
Team supervision
Managed care organization experience
Word embeddings
General ledger maintenance
Medicaid health insurance
Accounts payable management
Healthcare financial management
Medicaid
Productivity software
Financial management
Medical debt collection accounts
Collections account management
Patient collections management
Healthcare accounting

Full Job Description

Job Address:

100 Hresan Boulevard Fayetteville, WV 25840

Fayetteville Healthcare Center, a member of the CommuniCare Family of Companies, is currently recruiting for a Business Office Manager to join our team.

PURPOSE/BELIEF STATEMENT:

The position of Business Office Manager (BOM) is responsible for maintaining CommuniCare Health Services (CHS) business office policies and procedures and direct supervision of the Assistant BOM. The BOM must be able to effectively communicate with the Executive Director, Regional Team, and Business Office Staff as well as interact effectively with external clients such as families, attorneys, and outside agencies. The position must function as both a team member and leader to ensure that work is accomplished and quality service is delivered while supporting team members and leading the way in celebrating team successes. With a focus on delivering quality service, the position must also manage the resources within their control and assist others in managing resources.

JOB DUTIES & RESPONSIBILITIES

Complete weekly BOM Admission Checklist and present weekly at morning stand up to reduce exceptions
Verify and tie out the midnight census testing for validity and accuracy on a daily basis
Reference Policy Midnight Census
Complete admission procedures in absence of Admissions Coordinator
Conduct weekly Medicaid pending/collection blitz meeting with facility staff
Reference Policies Collection Blitz and Medicaid Pending Log and Meetings
Complete root cause analysis on accounts that contribute to bad debt then advise Executive Director regarding types of issues identified and proposed solutions
Complete insurance forms per request
Attend Utilization Review (UR) and/or PPS meeting as necessary
Supervise, organize, evaluate, and monitor all business office support staff
Meet with resident/responsible parties upon admission and discharge to discuss financial obligations
Complete and coordinate tasks necessary for timely and accurate billing and collection.
Attend and participate in scheduled training, education classes, and orientation programs to maintain and enhance quality of care.
Maintain and work within established departmental, center, and home office policies and procedures, objectives, quality improvement program, and safety, environmental, and infection control standards.

QUALIFICATIONS KNOWLEDGE/SKILLS & ABILITIES

Must have 3 - 5 years’ experience in the business office of a Long Term Care facility
College degree in Business Administration, Accounting/Finance, or related field
Prior supervisory experience and management training.
Must possess a thorough understanding of Medicare. Medicaid, Private Insurance, Managed Care costing and analysis, personnel management, accounts receivable/collections, resident funds, accounts payable, general ledger, and management of information systems.
Must have the ability to make independent decisions when circumstances warrant such action.
Must be able to deal tactfully with team members, other staff, residents, family members, visitors, government agencies, and the general public.
Must be willing to seek out new methods and principles.
Must be able to use a computer literate and have a working knowledge of Microsoft Office but not limited to Excel and Word.

Benefits

As a CommuniCare employee you will enjoy competitive wages and PTO plans. We offer full time employees a menu of benefit options from life and disability plans to medical, dental, and vision coverage from quality benefit carriers. We also offer 401(k) with employer match and Flexible Spending Accounts.

About Us

Since 1984, CommuniCare Family of Companies has been committed to delivering exceptional, person‑centered care as a national leader in post‑acute services for individuals with chronic or complex conditions. Today, our more than 105 skilled nursing and long‑term care facilities serve nearly 13,000 residents at any given time.
To support our centers and ensure long‑term success and continuity of care, CommuniCare has developed integrated lines of business spanning the full continuum of care. These specialized solutions include chronic disease management, memory care, telehealth services, Medicare insurance plans, behavioral health programs, and comprehensive medical services. Together, they enable us to deliver sophisticated, coordinated, and transformative care beyond the walls of our facilities.
Our mission, Serve with Pride, is evident in the quality and consistency residents, families, and community partners have come to expect and trust. With more than 14,000 employees serving communities across Ohio, Indiana, Virginia, and West Virginia, we are dedicated to improving the lives of our residents by placing extraordinary service above all else.
We continue to raise the bar and innovate wherever possible to enhance quality of life—creating environments where residents feel at home, employees thrive, and families find comfort and confidence in the care we provide.

Apply Now

Refine Your Search

utilization review jobs in beckley, wv

Business Office Manager

Care Manager

Nurse Practitioner (F2F)

Medical Director of Advisory Services

Regional Medical Director, Physical Medicine and Rehabilitation (PM&R)

Psychiatric Mental Health Nurse Practitioner (PMHNP) (In-person)

Appeals Professional III (Licensed Clinician)

Claims Nurse (Utilization Management / Claims Review) Must have CALIFORNIA license

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