UM Specialist

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

📋 Description

• Confirms the mental health, intellectual disability, and/or substance abuse benefits of clients and secures initial authorization as well as any subsequent authorizations as required by the guarantor.

• Validates all commercial and Medicare Advantage plans for the agency at the point of intake and monitors all documentation related to changes in these guarantors.

• Processes daily reports to advance authorizations through their lifecycle, from intake to discharge.

• Communicates the needs of guarantors to the operations team.

• Extracts essential information from charts for retroactive reviews and appeals.

• Collaborates with and educates operations staff regarding the authorization process and the status of their clients' requests.

• Establishes a tracking system to secure future authorizations and manage any additional requirements imposed by the guarantor.

• Addresses billing issues and/or receives updates from insurance providers.

⛳️ Requirements

• High School diploma required; an Associate degree is preferred.

• Minimum of two years of administrative experience.

• Strong observational skills, analytical thinking, problem-solving abilities, and effective verbal and written communication skills.

• Fundamental understanding of managed care and reimbursement principles.

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

• Outstanding 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

• 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 and/or work-related issues that may affect their job performance, health, mental, and emotional well-being