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    Utilization Management Coordinator - Los Angeles, United States - 360 Behavioral Health

    360 Behavioral Health
    360 Behavioral Health Los Angeles, United States

    1 week ago

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    Description

    Job Category :
    Z&S Management Chatsworth Support CenterRequisition Number : UTILI002763Apply nowPosted : April 26, 2024Full
    • TimeLocations Showing 1 locationVan Nuys, CA 91406, USADescription 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 WorkWhat 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 ResponsibilitiesLive the Companys 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 clients 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 HavesHigh 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, self-motivated, 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 office-based environment and collaborate effectively with others across all levels and functional areas of the organization.

    What we offer$22.00-$24.00/hourly.
    Monday
    • Friday 8:00am 5:00pmHybrid.

    Must be in office on ThursdaysHealth Benefits:

    Medical, Dental and VisionCompany covers 100% of dental and vision.401(K) retirement savings program360 Behavioral Healthis an equal opportunity employer.

    If anyone is unable to fully access any portion of the 360 Behavioral Health on-line system, we are committed to providing reasonable accommodations.

    Please contact us at for assistance.
    EEO/Minorities/Females/Disabled/VeteransOur organization is an equal employment/affirmative action employer.

    If you need accommodation for any part of the employment process because of a medical condition or disability, please send an e-mail to let us know the nature of your request.

    For more EEO information about applicant rightsclick here.
    AmericansWith Disabilities Act360 Behavioral Health, does not discriminate on the basis of disability in its services, programs, or activities.


    Employment:
    360 Behavioral Health does not discriminate based on disability in its hiring or employment practices and complies with the ADA title I employment regulations


    Effective Communication:

    360 Behavioral Health will, upon request, provide auxiliary aids and services leading to effective communication for people with disabilities, including qualified sign language interpreters, assistive listening devices, documents in Braille, and other ways of making communications accessible to people who have speech, hearing, or vision impairments.


    Modifications to Policies and Procedures:

    360 Behavioral Health, will make reasonable modifications to policies and procedures to ensure that people with disabilities have an equal opportunity to enjoy programs, services, and activities.

    For example, people with service animals are welcomed in 360 Behavioral Health offices, even where pets and other animals are prohibited.


    Requests:

    To request an auxiliary aid or service for effective communication, or a modification of policies or procedures contact [ADA Coordinator name and contact information] as soon as possible, preferably 30 days before the activity or event.

    For inquiries, please contact us at .comQualifications Education Required High School or better.

    Experience Required

    1 year:

    1 year:
    Understanding of insurance processes and procedures


    1 year:

    1 year:
    Ability and understanding of insurance authorizations.#J-18808-Ljbffr
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