Inpatient utilization management specialist

Job Details:

Job Location: 1700 EDUCATION AVE - PUNTA GORDA, FL 33950

Position Type: Part Time

Education Level: High School

Salary Range: $16.50 - $18.50 Hourly

Travel Percentage: Negligible

Job Shift: Day

Job Category: Insurance

Sign-on Bonus: $500

Work days: Saturday and Sunday

Participate in daily treatment team meetings in Crisis Services programs for the purpose of identifying new patients and communicating with them to determine financial income information, behavioral health and Substance Abuse insurance coverage as well as prescription medication insurance coverage. Attempt to obtain copies of insurance cards or other documentation from the patient or patient’s family/friends should intake staff be unable to procure at admission. Verify benefit coverage for all identified insurance plans, and communicate responsibilities to patients. Provide timely and accurate clinical information to third party payers as needed to assure coverage for inpatient treatment services. Provide feedback to nursing and administrative staff regarding need for documentation, denial of payment for patient treatment, or need for doctor-to-doctor consultation to assure coverage of treatment. Draft insurance appeals as needed. Responsible to assist in the reporting of ACSU Daily Census reporting, required by CFBHN.

Benefits:

• Full-time Dental, vision, health, and life insurance.
• Employee Assistance Program (EAP).
• Employer sponsored contribution to Health Savings Account (HSA), with qualifying insurance plan.
• Paid Time Off (PTO).
• 11 paid holidays.
• Must meet eligibility requirements 403b Retirement Plan, with 9% employer contribution for those who meet eligibility requirements.
• Tuition reimbursement, Public Service Loan Forgiveness (PSLF) eligible, and Health Resources and Services Administration (HRSA) loan repayment eligible for qualifying staff.

Qualifications:

• High school diploma or equivalent.
• Minimum of two (2) years’ experience in behavioral health field, preferred.
• Familiarity with health insurance, managed care organizations, third party payers and ASAM level of care criteria preferred.
• Preferred UM experience in a health related field.
• Ability to pass a level II Background clearance and drug test.

For more information regarding the Level II Background Screening click here.