UM Specialist - Remote Louisville Metro

Consideration will only be given only to candidates living in the Louisville Metro area.

• 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.

High School diploma:
Associate degree preferred.

Two years of administrative experience.

• 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.

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.

Seven Counties is the provider of choice for mental and behavior health services in and around the Louisville Metro. Over 1,400 employees work in 25+ locations throughout Bullitt, Henry, Jefferson, Oldham, Shelby, Spencer and Trimble counties; making sure that the 31,000 people we serve annually have the best chance of living their best lives. At Seven Counties, we give our staff the opportunity to do what they do best with continued training, effective mentoring and competitive salaries and benefits.

In an effort to protect our employees, clients and community, we require the COVID and Influenza vaccinations for all employees.