UM Specialist - Remote

Seven Counties Services•Louisville, KY

3d•Remote

About The Position

Consideration will only be given only to candidates living in the Louisville Metro area. ESSENTIAL JOB FUNCTIONS Verifies client’s mental health, intellectual disability, and/or substance abuse benefits and obtains initial authorization and subsequent authorizations, as determined by guarantor. Verifies all commercial and Medicare Advantage plans for agency at intake and all reports related to changes to these guarantors. Works daily reports to move authorizations through life cycle of authorization from intake to discharge. Communicates guarantors needs to operations staff. Pulls necessary information from charts for retro reviews and appeals. Collaborates and educates operations staff on authorization process and status of their client’s request. Implements tracking system to obtain future authorizations and any other maintenance needed by guarantor. Resolves billing problems and/or receives insurance updates. The intent of this job description is to provide a representative summary of the major duties and responsibilities performed by incumbents of this job. Incumbents may be requested to perform job-related tasks other than those specifically presented in this description.

Requirements

Excellent observation skills, analytical thinking, problem-solving, and good verbal and written communication skills.
Basic knowledge of managed care and reimbursement concepts
Knowledgeable of medical terminology, CPT, HCPC, and revenue codes
Excellent customer service skills
High School diploma: Associate degree preferred.
Two years of administrative experience.

Responsibilities

Verifies client’s mental health, intellectual disability, and/or substance abuse benefits and obtains initial authorization and subsequent authorizations, as determined by guarantor.
Verifies all commercial and Medicare Advantage plans for agency at intake and all reports related to changes to these guarantors.
Works daily reports to move authorizations through life cycle of authorization from intake to discharge.
Communicates guarantors needs to operations staff.
Pulls necessary information from charts for retro reviews and appeals.
Collaborates and educates operations staff on authorization process and status of their client’s request.
Implements tracking system to obtain future authorizations and any other maintenance needed by guarantor.
Resolves billing problems and/or receives insurance updates.

Benefits

Medical Coverage
Dental Coverage
Vision Coverage
Flexible Spending Account
Health Savings Account
Short Term Disability
Long Term Disability - Company Paid
Competitive Compensation Packages
Life Insurance - Company Paid
Accidental Death & Dismemberment Insurance - Company Paid
403b Retirement Plan with Company Funded Matching
Retirement and Financial Planning Services
Tuition Assistance Plans
Loan Forgiveness options through federal programs (National Health Service Corps & Public Service Loan Forgiveness)
Student Loan Repayment Assistance
Clinical Supervision toward licensure and reimbursement for certain license applications
At Seven Counties Services training is one of our highest priorities. We provide company paid professional training for various skills, certifications, and continuing education
Opportunities for growth and movement - We encourage our employees to consider new growth opportunities with us
Leadership Academy for our rising stars, supervisors, and leaders
Seven Counties Services and Center for Clinical Excellence provide staff with industry best practices and processes
Paid Time Off - Generous PTO for Vacations, Illness, Personal Days, Etc. (10 Paid Holidays)
Flexible Work Schedules to promote a Healthy Work Life Balance
Employee Assistance Program - assists employees with personal problems and/or work-related problems that may impact their job performance, health, mental and emotional well-being