Utilization Management Specialist
Required skills
- authorization
- benefits
- intake
- HIPAA
- Microsoft Office
- Gmail
- client eligibility
- communication skills
Nice to have
- Central Reach
- EMR
Role summary
A values-driven ABA therapy provider for children with autism is seeking a Utilization Management Specialist. This role is responsible for establishing contact with new and current clients, managing authorizations, benefits, and clinic support. Key duties include processing intake packets, entering client information into the operating system, coordinating clinic space and provider availability, maintaining documentation, and completing authorization renewals. The ideal candidate will be self-motivated, organized, possess strong problem-solving and communication skills, and have a working knowledge of HIPAA regulations and EMR applications, with Central Reach being preferred. Proficiency in Microsoft Office or Gmail is also required.
Primary Responsibilites:
Conducting authorizations, benefits and clinic support for new intake and current clients.
Preferred Skills and Knowledge:
Excellent organization and problem-solving skills
Experience using electronic medical record applications (Central Reach preferred).
Working knowledge of HIPAA regulations
Excellent interpersonal skills, good oral and written communication skills
Good organization and time management skills
Must have good working knowledge of Microsoft Office or Gmail office tools (Word, Excel, PowerPoint)
Verify client information and benefits
Email Intake packets for new clients and monitor receipt
Enter accurate demographic, benefit, and authorization information for clients into operating system
Request Financial Agreements from Client Accounts
Monitor availability of clinic space and providers
Coordinate process flow with clinics and providers
Maintain accurate documentation of service requests, testing, referrals and authorizations
Oversee receipt of authorizations and creation of accurate authorizations in operating system
Actively participate in Intake meetings and collaborate with providers and clinics for best Intake practices
Complete authorization renewals
Verify client eligibility weekly
Other duties as assigned by the intake manager
Education and Experience:
Bachelor’s Degree preferred
Must be self motivated, driven, bring energy and good communication skills
Must convey a sense of passion about helping children with autism through ABA therapy
Time management and organization
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