D107 - C&A MH Crisis - Utilization Management Coordinator
River Edge Behavioral Health•Macon, GA
•Onsite
About The Position
The Utilization Management Coordinator role is focused on ensuring clients receive the appropriate level of behavioral health care while maintaining compliance with medical necessity, authorization, and documentation requirements. The position combines utilization review, care coordination, insurance authorization management, and administrative oversight within behavioral health services.
Requirements
- High School Diploma
- 1-3 years of utilization management experience
Nice To Haves
- Bachelors in helping profession such as social work, community counseling, counseling psychology, or criminology preferred
Responsibilities
- Create Connects batch files
- Retrieve and process response files from Beacon’s SFTP site
- Work Connects documents in rejected, denied, hold, no CID, multi-final payer and status appropriately
- Review discharge connects and flip to UM complete
- Manage and process BHL CSU authorizations and update Carelogic
- Review and process AC file for BHL CSU authorization
- Complete State Discharge process for Fulton locations
- Create PTRF referral via Beacon authorization request
- Review and process Connects documents in UM review
Benefits
- health, dental, and vision benefits
- paid vacation
- retirement plans
- Flexible spending accounts
- 11 Paid holidays
- Voluntary Life Insurance
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
