Posted 1 month ago
Utilization Management Specialist
AI Summary
The Utilization Management Specialist conducts authorizations, benefits verification, and clinic support to enable client intake and ongoing ABA therapy services.
About this role
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
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
Skills
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