UM Specialist - Remote open to Louisville Metro applicants only
Seven Counties Services
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- Location
- Louisville, KY
- Work style
- Remote only
- Job type
- Full time
- Posted
- Nov 3
- 2 days ago
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About the company
Seven Counties Services
Mental health care · 1,001 to 5,000 employees
What you'll do
- Verify client benefits and obtain initial and subsequent authorizations
- Verify commercial and Medicare Advantage plans at intake
- Work daily reports to move authorizations through their life cycle
- Communicate guarantors needs to operations staff
- Pull information from charts for retro reviews and appeals
- Collaborate with and educate operations staff on the authorization process
- Implement a tracking system for future authorizations and guarantor maintenance
- Resolve billing problems and receive insurance updates
What you need
- High School diploma
- Two years of administrative experience
- Excellent observation skills, analytical thinking, and problem-solving
- Good verbal and written communication skills
- Basic knowledge of managed care and reimbursement concepts
- Knowledge of medical terminology, CPT, HCPC, and revenue codes
- Excellent customer service skills
- Lift up to 20 pounds, with frequent lifting and/or carrying up to 10 pounds
- Education: a high school diploma or an associate degree
Key skills
managed carereimbursement conceptsmedical terminologyCPTHCPCrevenue codesanalytical thinkingproblem-solvingcustomer service skills
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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