Utilization Management Coordinator - Van Nuys, United States - 360 Behavioral Health

360 Behavioral Health

Verified Company

Van Nuys, United States

3 weeks ago

Posted by:

Mark Lane

beBee recruiter

Description

Who are we?

At 360 Behavioral Health, we take pride in our long-standing commitment to providing exceptional care for individuals impacted by autism and other developmental delays.

With over three decades of expertise, we are one of the original and most established Applied Behavior Analysis (ABA)-based behavioral health services authorities.

Today, 360 Behavioral Health is one of the top ABA, enhanced personal assistance and respite providers in the United States.

The commitment, dedication, and approach to care that guided our founders when they opened their doors continues to guide all we do today.

Our devotion to their philosophy landed us on the list for "The 5 Best ABA Therapy Providers for 2023", and to us being labeled as a certified "Best Place To Work"

What would this role do?

As a Utilization Management Coordinator, you report to the Supervisor of Utilization Management and partner closely with the Care Navigation & Intake teams.

Your focus is to ensure the company delivers an exceptional customer experience to all health plan representatives, local office partners and others as you process new and existing clients' service authorizations through the organization.

Role Responsibilities

Live the Company's business theory of Customer Focus, Total Participation, Continuous Improvement, Leadership, and Mutual Learning.
Coordinate insurance activities including eligibility and benefits verification, preauthorization for initial assessment services for new clients meeting admission requirements and who are interested in initiating services with the company, submitting ongoing authorization requests, submitting discharge and transfer documentation to funding sources.
Maintain status of all funding activities by recording details in the client's record in Lumary, confirming and uploading all documentation as required, and recording details into the Authorization Tracking and other documents as required.
Manage daily workload to ensure proper submission of funding source authorization requests through the UM process per established processes and protocols including timely follow up of all authorizations assigned.
Contribute as an active and enthusiastic member of the UM team, and continually monitor, evaluate, and make recommendations for enhancements to the utilization management process.
Participate in / contribute to the attainment of KPIs established for the department.
Ensure compliance with HIPAA and other relevant regulatory requirements.
Assist with other projects or initiatives that support improvements in the customer and clinic experiences.

Must Haves

High School graduate or equivalent.
Proven success in current and prior roles and responsibilities.
Proven understanding of insurance processes and procedures.
Ability and understanding of insurance authorizations.
Ability to work independently within established procedures.
Exceptional customer service attitude and acumen with a drive toward providing an exceptional customer experience with every interaction.
Superb oral and written communication skills.
Proactive, selfmotivated, curious, driven.
Computer savvy with thorough knowledge of Microsoft Office (Word, Excel, Outlook, PowerPoint).
Excellent organizational and time management skills.
Critical attention to detail, deadlines, and reporting.
Ability to function effectively in an officebased environment and collaborate effectively with others across all levels and functional areas of the organization.