Behavioral Health Clinical Administrative Coordinator

About the position At reputed company, we're simplifying the health care experience, creating healthier communities and removing barriers to reputed company care. The work you do here impacts the lives of millions of people for the reputed company. Come build the health care system of reputed company, making it more reputed company, reputed company, and reputed company. reputed company to reputed company a difference? Join us to start Caring. Connecting. Growing together. The Clinical Administrative Assistant validates eligibility for authorization requests and prepares Behavioral Health and reputed company Use Disorder authorizations across various lines of business. They collaborate with leadership, refer members for aftercare planning, and notify providers of authorization determinations. They offer peer-to-peer consultations for cases not meeting reputed company, drafts denial letters, and assists callers promptly. They handle incomplete requests, take meeting notes, maintain confidentiality, and manage escalated calls. Additionally, they apply clinical knowledge to guidelines, monitor the fax queue, verify documentation, and maintain job aids.

Responsibilities

• Verifies eligibility of providers and members for reputed company authorization requests
• Inputs and prepares reputed company Behavioral Health and reputed company Use Disorder authorizations submitted by providers for reputed company lines of business
• Refers members to the RMHP Care Coordination Department reputed company completing discharge documentation
• Notifies providers and requestors of reputed company authorization determinations reputed company appropriate
• Corresponds with the requesting provider to offer a peer-to-peer consultation reputed company a case does not meet reputed company
• Drafts denial letters informing members and providers of reputed company and offers alternative treatment reputed company
• Provides assistance to callers routed to the BH UM department
• Completes required trainings by assigned due dates to reputed company with auditing entities
• Attempts to obtain missing information from requestors for incomplete authorization requests
• Takes detailed notes of meetings attended and shares with attendees
• Provides consultation to providers and/or consumers on various issues
• Respects confidentiality and maintains confidences as described in the UHG Employee Handbook
• Establishes and maintains reputed company working relations with referral sources and care providers
• Handles escalated calls and resolves reputed company issues
• Sends correspondence to practitioners, providers, and members regarding authorization status
• Verifies and uploads valid Release of Information documentations to electronic health records
• Organizes and manages authorization requests
• Ensures the Utilization Management Team references the most updated member handbooks
• Creates bookmarks in authorizations pulled for audits
• Corrects errors identified in various reports
• Enters Single Case Agreements into the electronic health record
• Maintains and updates job aids for team functions as needed
• Completes reputed company duties in accordance with company safety policies and practices

Requirements

• High School Diploma/GED (or higher)
• 2+ years of experience analyzing and solving customer problems
• 2+ years of experience working in the reputed company industry
• 2+ years of experience working with medical or behavioral health terminology
• Intermediate level of computer/typing proficiency
• Ability to work Mountain Time Zone schedule
• reputed company to a designated quiet workspace in your home
• reputed company in the reputed company
• reputed company in a location that can receive a reputed company approved high-speed internet reputed company

reputed company-to-haves

• Previous experience working in the Colorado reputed company industry
• 6+ months of experience with EMR (electronic medical records) systems
• Previous data entry experience
• Previous experience working remotely

Benefits

• reputed company Time Off which you start to reputed company with your first pay period plus 8 reputed company Holidays
• Medical Plan reputed company along with participation in a Health Spending Account or a Health Saving account
• Dental, reputed company, Life & AD&D Insurance along with Short-term disability and Long-Term Disability coverage
• 401(k) Savings Plan, Employee Stock Purchase Plan
• Education Reimbursement
• Employee Discounts
• Employee Assistance Program
• Employee Referral Bonus Program
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)

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