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Utilization Management Specialist

CharlotteOn-siteFull-time

AI Summary

Establishes and manages client authorizations, benefits, and intake support for ABA therapy; coordinates with clinics, verifies eligibility, and maintains documentation to ensure smooth entry and ongoing authorization for families seeking services.

About this role

The Southeast's Premier ABA Therapy Provider for Children with Autism, We are a values-driven company and are dedicated to providing world-class ABA therapy services to our early childhood patients while promoting a positive and supportive culture for our team members. Top 5% nationally in employee satisfaction! Top 3% nationally in client family satisfaction!
The Utilization Management Specialist is responsible for establishing a professional and supportive contact for clients seeking to enter ABA therapy and for current clients receiving ABA services.

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

    Authorization ManagementAuthorization RenewalsCentral ReachClarity Around Clinic Space And Provider CoordinationData EntryDemographic And Benefits VerificationDocument ControlElectronic Medical Records (EMR) SystemsGmailHIPAA ComplianceIntake CoordinationMicrosoft Office (Word, Excel, PowerPoint)OS/operating System Data EntryPhone And Email CommunicationReferral And Testing CoordinationScheduling Coordination

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