UM Specialist - Remote open to Louisville Metro applicants only

Job Description:

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.

EDUCATION

High School diploma: Associate degree preferred.

EXPERIENCE

Two years of administrative experience.

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

PHYSICAL DEMANDS

• •The position requires lifting up to 20 pounds, with frequent lifting and/or carrying of items weighing up to 10 pounds.
• •Occasional minor discomfort from continual exposure to a video display terminal.

Within the bounds of their respective job descriptions, all staff are expected to exercise principle-centered leadership, focusing on customer service responsiveness and continuous quality improvement. Additionally, all staff are expected to develop a working knowledge of and follow all policies and procedures related to safety management and other Joint Commission standards.

Time Type:

Full time