UM Specialist

This is a fully remote position, open to applicants in Kentucky.

📋 Description

• Validate clients’ benefits for mental health, intellectual disabilities, and/or substance abuse.

• Secure initial and follow-up authorizations as required by the guarantor.

• Confirm commercial and Medicare Advantage plans during intake and communicate any changes from the guarantor.

• Manage daily reports to transition authorizations from intake to discharge.

• Convey guarantor requirements to operational staff.

• Extract information from charts for retrospective assessments and appeals.

• Partner with and inform operations staff about authorization processes and the status of requests.

• Establish tracking systems for future authorizations and guarantor management.

• Address billing issues and obtain updates from insurance providers.

• Demonstrate principle-centered leadership with an emphasis on customer service responsiveness and continuous quality enhancement.

⛳️ Requirements

• Only candidates residing in the Louisville Metro area will be considered.

• A High School diploma is required.

• An Associate degree is preferred.

• A minimum of two years of administrative experience is necessary.

• Strong observational skills are essential.

• Capable of analytical thinking and problem-solving.

• Proficient verbal and written communication skills are needed.

• Basic understanding of managed care and reimbursement principles is required.

• Familiarity with medical terminology, CPT, HCPC, and revenue codes is beneficial.

• Outstanding customer service abilities are necessary.

• Must be able to lift up to 20 pounds, with frequent lifting and/or carrying of items weighing up to 10 pounds.

• Capability to adhere to policies and procedures related to safety management and Joint Commission standards is required.

🏝️ Benefits

• Opportunity for remote work.

• Full-time employment status.