UM Specialist - 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 job 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
Nice To Haves
- Associate degree preferred.
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
- Company paid professional training for various skills, certifications, and continuing education
- Opportunities for growth and movement
- Leadership Academy for our rising stars, supervisors, and leaders
- 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
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
