Utilization Management Specialist

UTILIZATION MANAGEMENT SPECIALIST

Elder Services of Worcester Area, Inc., is seeking a full-time Utilization Management Specialist to support and strengthen our authorization and billing processes. This position is a hybrid role, with a minimum of two days per week in the office and the potential for additional in-office days as operational needs require. The Utilization Management Specialist supports the accuracy, integrity, and timeliness of programs authorizations, prior approvals, service utilization data, and related financial records. The position ensures alignment between authorized services, service delivery, and billing documentation; identifies and reports discrepancies; and provides program and finance staff with complete and accurate information for audits, monitoring, reporting, and reimbursement. The role collaborates with program supervisors and fiscal staff to resolve variances and maintain current authorization records in accordance with agency standards and contractual requirements. High School diploma required, with a minimum of 1 year of experience in claims or insurance billing is required. Experience with authorizations, billing support, or compliance documentation is preferred. Must have strong interpersonal skills, adhere to confidentiality in all aspects of the position, and possess a willingness to learn. Must have moderate physical mobility. Ability to lift and carry objects weighing up to 15 pounds. Ability to multi-task, establish priorities, keep accurate records, and have strong attention to detail, within a fast-paced environment. Computer proficiency, including experience with Microsoft products (Excel, SharePoint, Word) and Outlook required.

Non-negotiable salary of:

$47,541-$48,555 annually A staged

HIRING BONUS

will be awarded in 2 parts, half at 120 Days, and half at 1 year of active employment. The bonus for this position is $1,000.

Benefits:

No holidays or on-call Flexible schedules specifically designed for work/home balance Rich benefits package Pension and 4.4 weeks of annual earned vacation time 12 paid holidays Paid sick days Mileage reimbursement: .725 per mile Affordable health insurance Excellent work environment Please submit resume. Come join our extraordinary team as our agency grows and expands and help make a difference in the lives of those that we serve! AA/EOE, including disability/veteran.

Pay:

$47,541.00 - $48,555.00 per year

Benefits:

Employee assistance program Flexible schedule Health insurance Life insurance Paid time off Retirement plan

Work Location:

Hybrid remote in Worcester, MA 01606