Behavioral Health Coordinator

Blue Cross and Blue Shield of Louisiana

About The Position

The Behavioral Health Coordinator provides administrative support throughout Louisiana Blue’s behavioral health authorization process. This includes answering phone calls routed to Behavioral Health Utilization Management, monitoring work queues within Epic, Enterprise Workflow, and fax systems. Authorized to enter specific types of authorizations and will call members and providers to obtain additional information for requests and to notify of approvals. Will provide other types of non-clinical support to the Behavioral Health Department. How You Contribute to the Company’s Mission In This Role Answers incoming phone calls regarding authorization requests and initiates processing of the request or routes to appropriate Utilization Review staff. Provides member/provider notification of authorization approvals and guidance for non-clinical questions regarding authorizations, such as where to locate the pre-authorization form on Blue Cross Blue Shield of Louisiana’s website and assists with provider requests for emailing or faxing the pre-authorization form. Assists with collection of data and enters pre-authorizations in Epic or other data systems under the supervision of appropriately licensed health professionals. This may include demographic information (e.g. patient’s name, date of birth, ordering physician, where services are to be performed, date of service, etc.) Approves services based on set criteria where no clinical judgment is required. Assists with the preparation and distribution of written notifications for authorization decisions made by the Behavioral Health Department. Reviews correspondence for errors prior to sending. Assists with timely processing and distribution of incoming faxes, emails and phone requests for behavioral health authorizations. This includes US postal mail delivery, external faxes, personal delivery, internal emails, and web-based portals. Research databases and systems such as Acuity, VNET, QNXT, Facets, Epic, and other systems to determine if incoming requests are duplications of existing authorizations or new requests, forwarding misrouted request to the appropriate departments, and initiating workflow to the appropriate persons within the department Appropriate labeling and identifying time/date of receipt of authorization requests along with the processing priority (standard or expedited) for each incoming request Assists with the routine review of daily error reports to identify and correct data entry errors. Other duties as assigned

Requirements

High school diploma or equivalent
1 year of customer service or medical office experience required
Proficient in Microsoft Office Suite (Excel, Word, Power Point, etc.)
Highly organized and efficient with strong attention to detail
Ability to multitask and prioritize in a fast-paced, ever-evolving environment
Excellent verbal and written communication skills
Ability to interact effectively with all levels of staff

Nice To Haves

Previous experience in a healthcare or insurance setting
Medical terminology knowledge
Previous experience dealing with utilization management
Ability to type minimum of 40 WPM

Responsibilities

Answers incoming phone calls regarding authorization requests and initiates processing of the request or routes to appropriate Utilization Review staff.
Provides member/provider notification of authorization approvals and guidance for non-clinical questions regarding authorizations
Assists with collection of data and enters pre-authorizations in Epic or other data systems under the supervision of appropriately licensed health professionals.
Approves services based on set criteria where no clinical judgment is required.
Assists with the preparation and distribution of written notifications for authorization decisions made by the Behavioral Health Department.
Assists with timely processing and distribution of incoming faxes, emails and phone requests for behavioral health authorizations.
Research databases and systems such as Acuity, VNET, QNXT, Facets, Epic, and other systems to determine if incoming requests are duplications of existing authorizations or new requests, forwarding misrouted request to the appropriate departments, and initiating workflow to the appropriate persons within the department
Appropriate labeling and identifying time/date of receipt of authorization requests along with the processing priority (standard or expedited) for each incoming request
Assists with the routine review of daily error reports to identify and correct data entry errors.
Other duties as assigned