Bradford Health Services

• Perform follow-up on aged accounts receivable to ensure timely resolution of balances • Review and analyze payer denials, identify trends, and take corrective action as needed • Conduct thorough reviews of patient accounts during the follow-up process to ensure accuracy and completeness of billing • Submit accurate and complete claims to insurance companies within one (1) business day of creation • Track and follow up on outstanding claims within 14 days of submission and at regular intervals thereafter until resolution • Communicate with patients regarding outstanding balances and establish payment arrangements when appropriate • Follow up on patient account balances within 30 days of statement mailing and regularly thereafter until resolution • Maintain accurate and up-to-date collection notes in the electronic system in compliance with organizational policies • Provide regular updates to the Revenue Cycle Operations Manager and other stakeholders regarding account activity and escalations • Serve as a professional point of contact for internal and external stakeholders, including insurance companies, patients, and third-party vendors • Escalate unresolved or complex issues to the appropriate supervisor in a timely manner • Adhere to the provisions of 42 CFR Part 2 (Confidentiality of Alcohol and Drug Abuse Patient Records) and 45 CFR (HIPAA) • Ensure all credit information and patient account details remain confidential • Provide courteous and professional assistance to patients, families, and payer representatives • Foster positive working relationships with colleagues, managers, and external contacts • Review and recommend accounts for outside collection when necessary • Participate in training and professional development activities as required • Perform other duties as assigned to support the team and organizational goals

Title: Medical Director Location: Knoxville, TN United States Job Description: Evolve Addiction Treatment programs meet each individual where they are, providing compassionate, evidence-based care that addresses substance use disorders and prepares patients for long-term success. Whether through counseling, peer support, medication-assisted treatment (MAT), or gender-specific programs, we offer a holistic approach to healing that encompasses the mind, body, and spirit. We are looking to add a Medical Director to our dynamic team. Founded by recovery advocates in 2019, Evolve Addiction Treatment was created to deliver personalized and affordable care to those seeking freedom from addiction. We treat the whole person, not just their symptoms. We understand that addiction often coexists with mental health challenges, trauma, and emotional pain. Our multidisciplinary team of addiction specialists, therapists, and recovery advocates provides integrated solutions that address these complexities, helping patients build a solid foundation for a fulfilling life in sobriety. Position Type - PRN Employment - Hourly Compensation - Predominately Remote - Position requires 1 (one) day of onsite attendance weekly Responsibilities - Assure that patient's medical history and physical examination is completed within twenty-four (24) hours of campus admission - Supervision of staff medical personnel, as designated - Routine medical visits and treatment as requested or as indicated - Formulation of standing orders in conjunction with Corporate Medical Director - Assure that patients are referred to proper agencies when treatment is beyond our scope - Provide admission, transfer and discharge orders - Participate in utilization review - Attend and participate in clinical staffing - Facility leadership with regards to new findings in the field of addictions treatment - Assure twenty-four (24) hour, seven (7) day weekly medical coverage - Must be able to work in a cooperative manner with co-workers, managers, clients and prospective clients - Must be able to work in constant state of alertness as to perform the job in a safe manner Qualifications - Medical degree from an accredited college/university and currently licensed - Continuing education as required for state licensure/certification as recommended by state or national professional association - Minimum of four (4) years' experience in alcohol/drug treatment - If recovering, must have four (4) years of continuous verifiable abstinence - Must be emotionally and physically capable of functioning under stressful situations - Maintain records and have good communication skills - Must have valid state driver's license We're officially a Great Place To Work! We've always believed that supporting our team is just as important as supporting our patients. Now, we're proud to share that we've earned Great Place To Work Certification - based entirely on feedback from our own employees. Read more here: https://ow.ly/YQ1C50WuRH1 This certification reflects the culture we've worked hard to build - one rooted in trust, inclusion, and purpose-driven leadership. At Bradford Health Services, we are committed to providing exceptional care to our patients while fostering a supportive and rewarding workplace for our employees. We believe that taking care of our team allows them to take better care of others, which is why we offer a comprehensive benefits package designed to support their well-being. At Bradford Health Services, we don't just invest in our patients-we invest in our people. - Medical Coverage - Three new BCBSAL medical plans with better rates, improved co-pays, and enhanced prescription benefits. - Expanded Coverage - Options for domestic partners and a wider network of in-network providers. - Mental Health Support - Improved access to services and a new Employee Assistance Program (EAP) featuring digital wellness tools like Cognitive Behavioral Therapy (CBT) modules and wellness coaching. - Voluntary Coverages - Pet insurance, home and auto insurance, family legal services, and more. - Student Loan Repayment - Available for nurses and therapists. - Retirement Benefits - 401(k) plan through Voya to help employees plan for the future. - Generous PTO - A robust paid time off policy to support work-life balance. - Voluntary Benefits for Part-Time Employees - Dental, vision, life, accident insurance, and telehealth options for those working 20 hours or more per week. Flexible schedule and hours (20-25 hours biweekly). Position would require 1 (one) day of onsite attendance weekly.

Title: Therapist Location: Chesterton United States Job Description: Parkdale Center is a specialized addiction treatment program focused on serving professionals in recovery. Parkdale focuses on treating professionals across the United States in highly accountable industries who struggle with addiction. Our facility utilizes innovative programs and solutions that meet those struggling with substance use disorder. We are currently seeking an experienced PRN Therapist to join our PHP/IOP team on a as needed basis. Responsibilities - Conducting intakes and comprehensive assessments - Facilitating group therapy and individual counseling sessions - Case management and treatment planning - Providing psychoeducation - Leading family sessions when appropriate - Collaborating with multidisciplinary treatment providers Qualifications - Strong knowledge and experience with the 12-Step recovery model - Master's degree in counseling, social work, or a related field - Current or provisional licensure preferred - LCAC / LCACA</li> - LMHC / LMHCA - LSW / LCSW - Graduate students welcomed to apply Schedule: - PRN Day Shifts - Rotating Saturdays and Sundays (Day Shifts) - Possible Evening Remote Virtual Sessions, up to 3 days/week (3-hour IOP sessions) If you're passionate about supporting professionals in recovery and value a collaborative, high-quality treatment environment, we would love to connect. PRN Day Shifts Rotating Saturdays and Sundays (Day Shifts) Possible Evening Remote Virtual Sessions, up to 3 days/week (3-hour IOP sessions)

Title: Utilization Review Specialist Location: Dallas, TX, United States Requisition ID: 5230 Job Description: This is a PRN position About Company: We're officially a Great Place To Work! We've always believed that supporting our team is just as important as supporting our patients. Now, we're proud to share that we've earned Great Place To Work Certification - based entirely on feedback from our own employees. This certification reflects the culture we've worked hard to build - one rooted in trust, inclusion, and purpose-driven leadership. At Bradford Health Services, we are committed to providing exceptional care to our patients while fostering a supportive and rewarding workplace for our employees. We believe that taking care of our team allows them to take better care of others, which is why we offer a comprehensive benefits package designed to support their well-being. Our benefits include: - Medical Coverage - Three new BCBSAL medical plans with better rates, improved co-pays, and enhanced prescription benefits. - Expanded Coverage - Options for domestic partners and a wider network of in-network providers. - Mental Health Support - Improved access to services and a new Employee Assistance Program (EAP) featuring digital wellness tools like Cognitive Behavioral Therapy (CBT) modules and wellness coaching. - Voluntary Coverages - Pet insurance, home and auto insurance, family legal services, and more. - Student Loan Repayment - Available for nurses and therapists. - Retirement Benefits - 401(k) plan through Voya to help employees plan for the future. - Generous PTO - A robust paid time off policy to support work-life balance. - Voluntary Benefits for Part-Time Employees - Dental, vision, life, accident insurance, and telehealth options for those working 20 hours or more per week. At Bradford Health Services, we don't just invest in our patients-we invest in our people. About the Role: The Utilization Review Coordinator plays a critical role in ensuring that patients at our facility receive the appropriate level of care while managing treatment costs. This position involves coordinating, assessing, and authorizing treatment plans, collaborating with medical staff, and maintaining compliance with healthcare regulations. The Utilization Review Coordinator works closely with insurance companies, clinicians, and support staff to ensure that treatment plans are clinically appropriate and reimbursable, advocating for the best interests of the patients and the hospital. Key Responsibilities: - Case Review and Assessment - Conduct daily reviews of patient charts, treatment plans, and progress notes to determine if the level of care provided aligns with clinical guidelines and insurance requirements. - Monitor patient progress, reassess treatment needs, and recommend adjustments in care levels as needed. - Collaborate with clinical teams to understand patient needs, assess treatment efficacy, and make informed recommendations. - Insurance Coordination - Act as the primary point of contact with insurance providers for treatment authorization, concurrent review, and appeal processes. - Submit required documentation to insurance companies in a timely manner, including clinical updates, to secure and maintain treatment authorization. - Resolve reimbursement issues, advocating for patient treatment needs and securing necessary approvals. - Documentation and Compliance - Ensure all documentation is complete, accurate, and in line with state, federal, and hospital policies to facilitate compliance and quality audits. - Maintain a working knowledge of current insurance guidelines, DSM-5 criteria, and ASAM (American Society of Addiction Medicine) criteria. - Participate in internal and external audits, preparing records and reports as necessary. - Collaboration and Communication - Work closely with medical and support staff to ensure continuity of care and that utilization review processes are aligned with patient needs. - Provide guidance to clinical staff regarding documentation best practices and criteria required for continued care authorizations. - Participate in multidisciplinary team meetings to discuss patient care plans, discharge planning, and treatment adjustments. - Quality Improvement - Identify trends in denied claims or treatment authorizations, providing recommendations for process improvements. - Assist in training hospital staff on utilization review processes, criteria for different levels of care, and effective documentation practices. - Collaborate in developing policies to improve efficiency, patient care outcomes, and financial performance. Qualifications: - Education: Bachelor's degree in Nursing, Social Work, or a related field required. Master's degree in a health-related field preferred. - Experience: Minimum of 2 years in utilization review, case management, or related field, preferably within a behavioral health or chemical dependency setting. - Licensure: Current RN, LCSW, or LPC license preferred. - Skills and Competencies: - In-depth understanding of mental health, substance abuse treatment and ASAM criteria. - Strong analytical and critical thinking skills with the ability to make clinical judgments based on patient data. - Excellent communication and interpersonal skills to facilitate interactions with insurers, staff, and patients. - Proficiency with electronic medical records (EMR) and utilization review software. - Knowledge of state, federal, and industry regulations related to chemical dependency and mental health care. Working Conditions: - Full-time, primarily daytime hours, with occasional on-call duties or weekends as needed. - Must be able to work in a high-paced environment and handle sensitive information with discretion. - Physical demands may include sitting for extended periods, light lifting, and using a computer for most of the workday.

Title: Utilization Review Specialist Location: Tuscaloosa United States Job Description: About Company: We're officially a Great Place To Work! We've always believed that supporting our team is just as important as supporting our patients. Now, we're proud to share that we've earned Great Place To Work Certification - based entirely on feedback from our own employees. This certification reflects the culture we've worked hard to build - one rooted in trust, inclusion, and purpose-driven leadership. At Bradford Health Services, we are committed to providing exceptional care to our patients while fostering a supportive and rewarding workplace for our employees. We believe that taking care of our team allows them to take better care of others, which is why we offer a comprehensive benefits package designed to support their well-being. Our benefits include: - Medical Coverage - Three new BCBSAL medical plans with better rates, improved co-pays, and enhanced prescription benefits. - Expanded Coverage - Options for domestic partners and a wider network of in-network providers. - Mental Health Support - Improved access to services and a new Employee Assistance Program (EAP) featuring digital wellness tools like Cognitive Behavioral Therapy (CBT) modules and wellness coaching. - Voluntary Coverages - Pet insurance, home and auto insurance, family legal services, and more. - Student Loan Repayment - Available for nurses and therapists. - Retirement Benefits - 401(k) plan through Voya to help employees plan for the future. - Generous PTO - A robust paid time off policy to support work-life balance. - Voluntary Benefits for Part-Time Employees - Dental, vision, life, accident insurance, and telehealth options for those working 20 hours or more per week. At Bradford Health Services, we don't just invest in our patients-we invest in our people. About the Role: The Utilization Review Specialist plays a critical role in ensuring that healthcare services provided to patients are medically necessary, efficient, and compliant with regulatory standards. This position involves thorough evaluation of patient records, treatment plans, and clinical data to determine the appropriateness of care and resource utilization. The specialist collaborates closely with healthcare providers, insurance companies, and case managers to facilitate timely approvals and optimize patient outcomes. By applying clinical knowledge and regulatory guidelines, the role helps control healthcare costs while maintaining high-quality patient care. Ultimately, the Utilization Review Specialist contributes to the integrity and sustainability of healthcare delivery systems across the United States. Minimum Qualifications: - Bachelor's degree in a healthcare or related field. - At least 2 years of experience in utilization review, case management, or clinical healthcare roles. - Strong knowledge of medical terminology, clinical procedures, and healthcare regulations. - Familiarity with insurance authorization processes and healthcare reimbursement models. - Excellent analytical, communication, and organizational skills. Preferred Qualifications: - Experience with electronic health records (EHR) systems and utilization management software. - Certification in Utilization Review (e.g., Certified Professional in Utilization Review or Certified Case Manager). - Prior experience working with managed care organizations or insurance companies. - Advanced knowledge of Medicare, Medicaid, and other payer-specific guidelines. Responsibilities: - Review and analyze medical records, treatment plans, and clinical documentation to assess the necessity and appropriateness of healthcare services. - Coordinate with healthcare providers, insurance representatives, and case managers to obtain additional information and clarify treatment details. - Make informed decisions regarding authorization, continuation, modification, or denial of services based on clinical guidelines and regulatory requirements. - Maintain accurate and detailed records of utilization review activities, decisions, and communications in compliance with organizational policies and legal standards. - Stay current with evolving healthcare regulations, payer policies, and clinical best practices to ensure consistent and compliant review processes. Skills: The Utilization Review Specialist applies clinical expertise and analytical skills daily to evaluate patient care plans against established medical criteria and payer policies. Effective communication skills are essential for collaborating with multidisciplinary teams, including physicians, nurses, and insurance representatives, to gather necessary information and explain review decisions. Organizational skills enable the specialist to manage multiple cases simultaneously while maintaining detailed documentation and meeting deadlines. Proficiency with healthcare IT systems supports efficient data retrieval and documentation of utilization review activities. Continuous learning and adaptability are important to stay updated on regulatory changes and evolving clinical standards, ensuring compliance and optimal patient care.

• Identify and qualify new business opportunities through research, networking, and outreach within the health care sector. • Engage with prospective clients via phone calls, emails, and meetings to understand their challenges and present appropriate health care service solutions. • Collaborate with internal teams to develop customized proposals and presentations that meet client requirements and regulatory standards. • Maintain accurate records of client interactions and sales activities using CRM software to track progress and forecast potential revenue. • Stay informed about industry trends, competitor offerings, and regulatory changes to provide insights that support strategic decision-making.