[Hiring] UM Specialist @Seven Counties Services

Role Description

• 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.

Qualifications

• High School diploma; Associate degree preferred.
• 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.

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 rising stars, supervisors, and leaders
• 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