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    Seven Counties Services, Inc.

    Mental Health Services

    UM Specialist - Remote open to Louisville Metro applicants only

    KY - 10401 Linn Station Rd Louisville - 56001, United StatesRemoteFull-timePosted 2w ago
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    Job description

    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

    Job details are sourced from the employer's original posting.

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    About the company

    Seven Counties Services, Inc.

    Seven Counties Services, Inc. is a non-profit organization providing mental health, developmental, and addiction services in Louisville, Kentucky.

    View all Seven Counties Services, Inc. jobs
    Industry
    Mental Health Services
    Open roles
    116

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