Clinical Services Coordinator, Intermediate (BH Intake)

Your Role

The Behavioral Health Services (BHS) Clinical Intake team is responsible for timely and accurate processing of Treatment Authorization Requests. The Behavioral Health (BH) Clinical Services Coordinator (CSC), Intermediate will report to the BH Manager of Clinical Intake. In this role you will be completing intake activities, based upon provider/facility requests, for Commercial and Medicare lines of business.

Your Work

In this role, you will:

• Work in a production-based environment with defined production and quality metrics
• Process phoned in Prior Authorization or Hospital Admission Notification Requests, Utilization Management (UM) requests and/or calls left on voicemail
• Data entry including authorization forms, high risk member information, verbal HIPPA authorizations information for case creation
• Assign initial Extension of Authority (EOA) days, or triage to clinicians, based on established workflow
• Research member eligibility/benefits and provider networks
• Assist with system letters, requests for information and data entry
• Provide administrative/clerical support to Behavioral Health Utilization Management Clinicians
• Other duties as assigned       

Your Knowledge and Experience

• Requires a high school diploma or equivalent
• Requires at least 3 years of prior relevant experience
• 1 year work experience in a call center environment preferred
• Working knowledge of the systems/tools utilized for UM authorization functions such as FACETS, MedHok, preferred  
• Knowledge of Behavioral Health treatment levels of care preferred
• Knowledge of health plan terminology preferred
• Ability to work in a high-paced production environment with occasional overtime needed (including weekends) required