Utilization Management Specialist

Utilization Management Specialist

The Southeast's premier ABA therapy provider for children with autism, we are a values-driven company 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 Responsibilities:

• 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