The Utilization Management Specialist gathers and verifies demographics; insurance coverage; and income qualifications for various funded programs. Performs data entry; collections; auditing; billing; reimbursement; and maintenance of Medical Software and provider enrollment. Obtains pre-certification and authorizations for managed care coverage to include the necessary follow up for billing and collection of these services. Knowledgeable of third party liability practices and reimbursement (Medicare; Medicaid; HMO Managed Care). Travel to various Harbor sites is required. Performs other duties as assigned.
High School Diploma / GED
AS Degree in Business
One year in Billing, Collections, or Medical Office
PREFERRED EXPERIENCE: Six months Provider Cer.
Written and verbal communication skills, customer service skills, interpersonal skills, organizational skills, computer skill appropriate to position, administrative and clerical skills, knowledge of regulatory requirements appropriate for position, teamwork, work independently with minimal supervision.
2610-BAYCARE BEHAVORIAL HEALTH
FL-Lutz-Morton Plant North Bay Recovery Center
Monday, Tuesday, Wednesday, Thursday, Friday
8:00AM - 5:00PM
BayCare - 17 months ago