Robert Mirek Email & Phone Number

Greater Wilmington Area

Land of the Dying Fire (Feature: Mystery/Crime/Thriller)1999 TRIP (Feature: Drama/Sci-Fi)https://www.networkisa.org/profile/robert-mirek

Wilmington, North Carolina Area

Wilmington, North Carolina Area

Wilmington, North Carolina Area

Wilmington, North Carolina Area

*Responsible for recruitment and management of Utilization Review employees at CRC Health Group’s Wilmington Treatment Center and New Life Lodge while acting as a resource for other CRC Facilities such as 12 Oaks and Four Circles when in need of assistance with Utilization Review duties. *Ensured the completion of prompt authorization requests weekly with insurance companies for 200+ cases for levels of care including Inpatient Detox, Inpatient Rehab, Residential, Partial and Intensive Outpatient.*Strong focus of cultivating relationships through the delivery of excellent customer service with patients, families, referral sources and Managed Care Organizations. *Direct telephone reviews with the physicians representing insurance providers regarding clinical and medical justification for higher levels of care, when necessary.*Completion of appeal letters for standard chart appeal purposes with insurance companies whenever claims issues would surface. *Review of Electronic Medical Records and communication with other Department Managers for Quality Assurance purposes. *Developed monthly and quarterly reports detailing specific breakdowns of average length of stay trends by level of care, complete episode, or by staff provider. Completion of other precise reports detailing unused, clinically appropriate authorized days and physician peer review outcomes. *Developed systems which increased average length of stay. *Participation in developing a yearly budget. *Direct collaboration with Senior Leadership Team, referral sources and Managed Care Organizations on ideas for and execution of new business development.

Wilmington, North Carolina Area

*Reviewing, preparing and presenting insurance providers clinical, medical and psycho-social data for case pre-certification to obtain authorization for Inpatient, Partial and Intensive Outpatient Hospitalization episodes.*Meeting with the clinical, medical, marketing and administrative staff to coordinate appropriate ongoing treatment goals and discharge planning.*Updating insurance providers weekly on patients’ mental status, physical conditions, medication changes, treatment plans and treatment complications/progress, and discharge information. *Conducted peer reviews and appeals with Managed Care Organization physicians when medical necessity for higher levels of care was in question.

Wilmington, North Carolina Area

*Screened crisis calls, conducted telephone and face to face interviews to obtain: clinical, medical, and insurance information to determine which potential patients met criteria for inpatient hospitalization. *Discussed and obtained approval from each department manager to proceed with scheduling new admissions. *Coordinated and supervised the arrival of new admissions, assisted clients, families and staff with proficient intake process, including the accurate signing of the required documents of consent.*Provided excellent customer service and patient care ensuring each new admission with an excellent on-boarding experience.*Received Employee of the Month award for strong work ethic and dedication.

Wilmington, North Carolina Area

*Assisted patients with understanding treatment structure and assisted treatment team with service delivery of daily program. *Received Employee of the Month award for strong work ethic and dedication.