Utilization Management Specialist

Job Description

Job Description

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

We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.