Clinical Services Coordinator

4 days ago


Chapel Hill, North Carolina, United States Brighton Health Plan Solutions, LLC Full time
Job Overview
Brighton Health Plan Solutions, LLC is seeking a skilled UM Coordinator to manage the prior authorization process and ensure seamless communication between members, providers, and facility staff.

The ideal candidate will possess excellent communication and problem-solving skills, with a solid understanding of medical terminology and third-party reimbursement regulations. You will work closely with the clinical team to address provider or member questions, issues, or concerns, and play an active role in continuous improvement activities and quality initiatives.

Responsibilities:
  • Verify member eligibility, plan participation, and provider participation status.
  • Collaborate with the clinical team to address provider or member questions, issues, or concerns.
  • Develop and maintain accurate documentation within the clinical record according to workflows, policies, and procedures.
  • Communicate effectively with internal and external stakeholders, including members, providers, and facility staff.
Salary Range: $70,000 - $90,000 per year, depending on location and experience.

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