UTILIZATION MANAGEMENT SPECIALIST I - (LUTZ/PRN/VARIES)
BayCare Health - Lutz, FL

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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.
      Qualifications
      REQUIRED EDUCATION: High School Diploma / GED

      PREFERRED EDUCATION: AS Degree in Business

      REQUIRED EXPERIENCE: One year in Billing, Collections, or Medical Office

      PREFERRED EXPERIENCE: Six months Provider Cer.

      SPECIFIC SKILLS: 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.

      Organization : 2610-BAYCARE BEHAVORIAL HEALTH
      Primary Location : FL-Lutz-Morton Plant North Bay Recovery Center
      Schedule : Monday, Tuesday, Wednesday, Thursday, Friday
      Shift : Days
      Shift Hours : 8:00AM - 5:00PM
      Weekend Work : None
      On Call : No

      BayCare - 17 months ago - save job - block
      About this company
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