Utilization Review & Entitlement Specialist at Douglas County Nebraska in Omaha, Nebraska

Job Description:

The Position



TYPING TEST REQUIRED: Your application will NOT be considered unless you take the typing test -


CLICK HERE to take the typing test now.




(NOTE): The first and last name you enter on the typing test and this application must be exactly the same. DO NOT PLACE A SPACE AFTER YOUR NAME AND DO NOT ENTER A MIDDLE INITIAL ON THE TYPING TEST. If the names are NOT an exact match (including upper and lowercase letters), your typing test score will not be uploaded into your application accurately, as it is completed through an automated process.




TYPING TESTS ARE VALID FOR SIX MONTHS.



Incumbent works under the direction of the Director of Outpatient Services or designee, performing utilization review activities for the Psychiatric Outpatient Program department, supporting billing functions for Region 6 Behavioral Healthcare, and ensuring and maintaining secure entitlements.


Essential Functions

• Maintain data management tracking system ensuring current financial status for clients.


• Establish and maintain effective work relationships with clients, supervisors, County employees, elected officials, attorneys, law enforcement, judges, other agencies, and the public.


• Comply with Civil Service Rules, collective bargaining agreements, County policies, department policies and laws to create a cooperative, safe, respectful and quality work environment.


• Conduct interviews (e.g. face-to-face, phone) assisting in the completion of required forms and procedures to receive third party payments (e.g. Medicare, Medicaid, insurance).


• Work with fiscal services, expediting third party payments and intervening with appropriate offices (e.g. Social Security, Veterans, Administration, Social Services) in obtaining needed information and documentation.


• Perform other entitlement services.


• Prepare progress and reconciliation reports on client entitlement status.


• Maintain knowledge of federal, state and local rules, regulations and procedures for third party eligibility, payments and other client benefits (e.g. Medicare, Medicaid, insurance, Veterans Affairs).


• Check in patients (e.g. appointments, Medicare and health insurance eligibility).


• Update Psychiatric Outpatient Chart with financial class designation notifying billing department and entitlements.


• Maintain Medicaid pre-authorization and ongoing authorization for medication management (e.g. psychotropic medications) and therapy patients.


• Complete billing entry and reimbursement request for Region 6 Behavioral Healthcare for CMHC programs.


• Update the Central Data System (CDS) with information required for Region 6 Behavioral Health authorization and billing.


• Conduct follow-up gathering information and determining reimbursement delays occur, completing adjustments, complying with reimbursement policies, and resubmitting billings .


• Enter patient registration and discharge information in the Nebraska Behavioral Health Systems (NBHS) (e.g. medication management, therapy).


• Maintain job knowledge and skills (e.g. research, meetings, webinars, seminars, conferences, continuing education).


• Respond to emergency codes assisting within level of competence and training; contact appropriate personnel for assistance and follow-up.


• Participate in quality assessment activities.


• Report to work with regular, consistent attendance.


• Perform other duties as assigned and directed.

Education and Work Experience and Other Requirements

• High school diploma or equivalent required.*


• Three (3) years of clerical experience required.*


• One (1) year of medical billing or accounts receivable experience required.


• One (1) year of behavioral health setting experience required.


• Two (2) years of MSOffice experience required.


• Current basic life support/cardiopulmonary resuscitation (BLS/CPR) and completion of Crisis Prevention Intervention (CPI) training within 12 months of hire required.


• Must be able to type/keyboard 45 net words per minute.


• Completion of a pre-employment criminal record check and conditional offer drug screen required.


• *Equivalent combination of education and work experience may be substituted for requirements on a year-for-year basis.

Physical Requirements & Working Conditions

• The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.


• Work is generally performed in a psychiatric facility. Noise level is usually moderate to loud. Work hours are typically standard day-shift hours; however, schedule may vary (e.g. weekends, holidays, overtime/extra hours, emergency call-in). Work may be stressful when dealing with time constraints, multiple/changing priorities, limited resources, uncooperative/irate individuals and emergency situations.


• Work requires some physical activity, including extended periods of sitting, frequent standing, walking, reaching, and occasional bending, kneeling, climbing, stooping, crouching, and balancing. Work also requires the ability to frequently lift/carry objects weighing up to 10 pounds and occasionally up to 25 pounds.


• Required sensory abilities include vision, hearing, and touch. Visual abilities, correctable to normal ranges, include close, distance and color vision, depth perception, and the ability to adjust focus. Communication abilities include the ability to talk and hear within normal ranges. Incumbent must possess the hand-eye coordination and manual dexterity necessary to operate computers and other equipment.

Douglas County is an EOE - Disability/Veterans


Douglas County offers a comprehensive benefit package including:

• Insurance including health, dental, vision, and life


• Pension


• Sick Leave


• Vacation Leave


• 13 Holidays


• Flex Spending Accounts


• Deferred Income plans (457 plan)


• EAP


• Health Savings Accounts

01

TYPING TEST REQUIRED: Your application will NOT be considered complete unless you take the typing test. If you haven't taken the typing test, go back to the job posting and click on the link. I UNDERSTAND THAT the first and last name I enter on the typing test and this application MUST BE EXACTLY THE SAME. DO NOT PLACE A SPACE AFTER THE LAST LETTER IN YOUR FIRST OR LAST NAME. If the names are NOT an EXACT MATCH (including upper and lowercase letters), your typing test score will NOT be uploaded into your application accurately, as it is an automated process. I UNDERSTAND that the typing test may reflect that I passed, but the determination of passing is based upon the typing speed requirement stated in the job posting and not the result provided by the typing website provider. NOTE: Typing Tests are valid for six (6) months. I understand this requirement and have completed my typing test.

• Yes
• No

02

What is the highest level of education you have completed?

• High school diploma/GED
• 1 year of college
• 2 years of college
• 3 or more years of college
• Bachelor's Degree

03

How many years of clerical experience do you have?

• Less than one year
• One year
• Two years
• Three years
• Four years
• Five or more years

04

Do you have at least one (1) year of medical billing or accounts receivable experience?

• Yes
• No

05

Do you have at least one (1) year of experience in a behavioral health setting?

• Yes
• No

06

Do you have at least two (2) years of MSOffice experience?

• Yes
• No

07

Current basic life support/cardiopulmonary resuscitation (BLS/CPR) and completion of Crisis Prevention Intervention (CPI) training is required within 12 months of hire. Do you understand this condition of employment?

• Yes
• No

08

Are you able to successfully perform the Essential Functions of the job with or without reasonable accommodation?

• Yes
• No

09

Are you able to meet the Physical Requirements and Working Conditions of this position with or without reasonable accommodation?

• Yes
• No

10

If you answer yes to claiming Veteran's Preference, you must attach to your application, before submission, a copy of your DD214 including page 4 identifying your character of service (and IF disabled, verification of disability from the VA), OR if you are a spouse of a 100% disabled veteran, you must attach a copy of your spouse's DD214, showing character of service, a copy of the veteran's disability verification from the Department of Veteran's Affairs demonstrating a 100% permanent disability rating, and proof of marriage to the veteran; OR if you are a spouse of an active service member, you must attach a copy of your spouse's active service orders and proof of marriage to the active service member. I understand this requirement that documents must be attached.

• Yes
• No
• I am not claiming Veteran's Preference

11

Are you able to work Monday through Friday from 8:00 am to 4:30 pm?

• Yes
• No

12

The pay range salary for this position is $24.40 to $36.87 per hour. Is this acceptable to you?

• Yes
• No

Required Question


Employer Douglas County (NE)

Address 1819 Farnam Street, Suite 505

Omaha, Nebraska, 68183

Phone 402-444-6188


Website http://hr.douglascounty-ne.gov/employment Apply Now