UM Specialist - Remote open to Louisville Metro applicants only

Seven Counties Services • Louisville, KY

7d • Remote

About The Position

Consideration will only be given only to candidates living in the Louisville Metro area. The UM Specialist verifies client’s mental health, intellectual disability, and/or substance abuse benefits and obtains initial authorization and subsequent authorizations, as determined by guarantor. This role verifies all commercial and Medicare Advantage plans for the agency at intake and all reports related to changes to these guarantors. The specialist works daily reports to move authorizations through the life cycle of authorization from intake to discharge, communicates guarantors needs to operations staff, and pulls necessary information from charts for retro reviews and appeals. This position collaborates and educates operations staff on the authorization process and status of their client’s request, implements a tracking system to obtain future authorizations and any other maintenance needed by guarantor, and 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
• Two years of administrative experience.
• High School diploma
• Candidates living in the Louisville Metro area only.

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED