Lauren Young, MSW
Lewisville,TX
Summary
Specializes in insurance policy verification, authorization processing accuracy, and patient data confidentiality management. Excel in communication, problem-solving, and time management to ensure seamless operations within healthcare settings.
Overview
8
8
years of professional experience
Work History
Admissions Liaison
Encompass Health Rehabilitation Hospital
Plano, TX
04.2024 - Current
- Receive and verify referrals from hospitals, physicians, and case managers
- Evaluate patient eligibility for rehabilitation programs based on medical stability, readiness, and insurance coverage
- Determine appropriate level of care and coordinate services
- Verify insurance benefits, facilitate pre-certification, and obtain authorizations
- Educate patients and families on rehab process, available resources, and discharge planning
- Collaborate with interdisciplinary teams to ensure smooth transitions and continuity of care
- Represent facility at marketing and community outreach events
- Assemble admission packets and manage referral data in hospital systems
- Communicate with physician offices, insurance carriers, and follow-up with patients
Utilization Review Coordinator
Universal Health Services, Inc.
Denton, TX
08.2021 - 04.2024
- Conduct utilization reviews including admission, continued stay, and discharge planning based on CMS and payer criteria
- Communicate with insurance providers to obtain authorizations and resolve denials
- Prepare detailed clinical reviews to justify medical necessity and support appeal processes
- Collaborate with physicians, nurses, and case managers to coordinate high-quality, cost-effective care
- Participate in departmental strategy meetings to align with payer policies and improve performance metrics
Therapist III
Little Creek Behavioral Health
Conway, AR
07.2020 - 09.2021
- Completed psychosocial assessments and developed individualized treatment plans
- Delivered group therapy and crisis intervention for adolescent populations
- Maintained detailed and timely clinical documentation for audits and compliance
- Contributed to discharge planning and facilitated aftercare referrals
PRN Social Worker
Psychiatric Medical Care
Benton, AR
07.2020 - 08.2021
- Assessed behavioral health patients and provided brief interventions in acute settings
- Supported discharge planning and coordinated follow-up services
- Led psychoeducational and therapeutic group sessions for adult and geriatric populations
Director of Case Management
Acadia Healthcare
Benton, AR
01.2017 - 07.2020
- Directed case management operations for inpatient psychiatric facility
- Implemented utilization review protocols and managed payer communications
- Provided leadership and training to case managers on UR procedures and compliance standards
- Engaged in complex case coordination and escalated appeals as necessary
Education
Master of Social Work -
University of Arkansas at Little Rock
Little Rock, AR05.2020
Bachelor of Science - Sociology
University of Central Arkansas
Conway, AR12.2016
Skills
- Utilization review and management
- Insurance authorizations and denials
- Concurrent and retrospective reviews
- Appeals and reconsiderations
- Discharge planning and case coordination
- Interdisciplinary collaboration
- MIDAS proficiency
- MS4 proficiency
- Allscripts proficiency
- CRM proficiency
- AceIT proficiency
Timeline
Admissions Liaison
Encompass Health Rehabilitation Hospital
04.2024 - Current
Utilization Review Coordinator
Universal Health Services, Inc.
08.2021 - 04.2024
Therapist III
Little Creek Behavioral Health
07.2020 - 09.2021
PRN Social Worker
Psychiatric Medical Care
07.2020 - 08.2021
Director of Case Management
Acadia Healthcare
01.2017 - 07.2020
Master of Social Work -
University of Arkansas at Little Rock
Bachelor of Science - Sociology
University of Central Arkansas
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