UM Specialist

🔥 13 hours ago

🐎 Kentucky – Remote

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⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 10%

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Logo of Seven Counties Services

Seven Counties Services

1001 - 5000 employees

🏥 Healthcare

⚕️ Healthcare Insurance

🤝 Non-profit

Healthcare • Healthcare Insurance • Non-profit

Seven Counties Services is a leading Community Mental Health Center and behavioral health services provider in Kentucky, serving individuals and families across Bullitt, Henry, Jefferson, Oldham, Shelby, Spencer, and Trimble counties. They offer a wide range of services including mental health support, addiction recovery programs, developmental services, and crisis stabilization. The organization is committed to providing quality care and health services, ensuring a positive approach tailored to individual needs, regardless of background or financial status. Additionally, Seven Counties Services emphasizes equity, diversity, and inclusion in their programs and initiatives, continually striving to improve the lives of those they serve.

📋 Description

• Verify clients’ mental health, intellectual disability, and/or substance abuse benefits • Obtain initial and subsequent authorizations as determined by guarantor • Verify commercial and Medicare Advantage plans at intake and report guarantor changes • Work daily reports to move authorizations from intake through discharge • Communicate guarantor needs to operations staff • Pull information from charts for retrospective reviews and appeals • Collaborate with and educate operations staff on authorization processes and request status • Implement tracking systems for future authorizations and guarantor maintenance • Resolve billing problems and receive insurance updates • Exercise principle-centered leadership focused on customer service responsiveness and continuous quality improvement

🎯 Requirements

• Consideration only for candidates living in the Louisville Metro area • High School diploma required • Associate degree preferred • Two years of administrative experience • Excellent observation skills • Analytical thinking and problem-solving skills • Good verbal and written communication skills • Basic knowledge of managed care and reimbursement concepts • Knowledge of medical terminology, CPT, HCPC, and revenue codes • Excellent customer service skills • Ability to lift up to 20 pounds, with frequent lifting and/or carrying of items weighing up to 10 pounds • Ability to follow policies and procedures related to safety management and Joint Commission standards

🏖️ Benefits

• Remote work • Full-time employment

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