Utilization Management Specialist

ABA Therapy 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.
• 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.