UM Specialist - Remote

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.

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.

Time Type:

We continually help our community and employees flourish... one life at a time. As a Seven Counties Services employee there are many benefits to enjoy. Below are just some of the great benefits you might be eligible for with Seven Counties Services.

• Health & Wellness
  • Medical Coverage
  • Dental Coverage
  • Vision Coverage
  • Flexible Spending Account
  • Health Savings Account
  • Short Term Disability
  • Long Term Disability - Company Paid

• Financial Wellbeing
  • 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

• Career Development and Growth
  • 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

• Work Life Balance
  • 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

At Seven Counties Services, we are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and employees without regard to race, color, religion, sex, pregnancy (including childbirth, lactation and related medical conditions), national origin, age, physical and mental disability, marital status, sexual orientation, gender identity, gender expression, genetic information (including characteristics and testing), military and veteran status, and any other characteristic protected by applicable law.