UM Specialist Remote for Louisville Metro candidates only

Seven Counties
life insurance, flexible benefit account, paid time off, paid holidays, short term disability, long term disability, tuition assistance, 403(b), retirement plan
United States, Kentucky, Louisville
Feb 11, 2025
Job Description: PURPOSE Position is open to Kentucky and Southern Indiana residents only. Some in office work while training may be required. 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 client's health insurance plan. Accurately identifies behavioral health payer per medical plan. Implements tracking system to obtain recertification of services, as needed, for psychiatrists, psychologists, licensed clinical social workers, and licensed professional counselors. Secures information about client's financial status or insurance coverage and, as needed, completes insurance forms, verifies insurance coverage, and secures other relevant information. Answers inquiries from clients, doctors' offices, or third-party payers and follows through to resolution. Understands and explains to clients and their families the charges, services, and bill payment policies applicable to them. Performs various administrative functions to complete and expedite the billing process including, but not limited to, recording client identification data and physician diagnosis, investigating charges, correcting and updating data, and preparing the claim to bill. Resolves billing problems and/or receives insurance updates. EDUCATION Completion of up to 18 months' additional business education beyond high school. EXPERIENCE Two to three years of related administrative experience in an insurance or managed care setting. Requires 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. Typing speed of 45 - 55 word units per minute. Basic computer skills. PHYSICAL DEMANDS Position requires lifting of 20 pounds maximum, with frequent lifting and/or carrying of items weighing up to 10 pounds. Occasional minor discomforts from continual exposure to video display terminal. Time Type: Full time We continually help our community and employees flourish... one life at a time. As a Seven Counties Services employee there are many benefits to enjoy. Below are just some of the great benefits you might be eligible for with Seven Counties Services. Health & Wellness Medical Coverage Dental Coverage Vision Coverage Flexible Spending Account Health Savings Account Short Term Disability Long Term Disability - Company Paid Financial Wellbeing 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 Career Development and Growth 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 At Seven Counties Services training is one of our highest priorities. We provide company paid professional training for various skills, certifications, and continuing education Opportunities for growth and movement - We encourage our employees to consider new growth opportunities with us Leadership Academy for our rising stars, supervisors, and leaders Seven Counties Services and Center for Clinical Excellence provide staff with industry best practices and processes Work Life Balance 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 At Seven Counties Services, we are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and employees without regard to race, color, religion, sex, pregnancy (including childbirth, lactation and related medical conditions), national origin, age, physical and mental disability, marital status, sexual orientation, gender identity, gender expression, genetic information (including characteristics and testing), military and veteran status, and any other characteristic protected by applicable law.