Clinical Operations Coordinator

7 days ago


Macon, Georgia, United States River Edge Behavioral Health Full time
About the Role

River Edge Behavioral Health is seeking a highly skilled Clinical Operations Coordinator to join our team. As a key member of our Utilization Management department, you will play a critical role in ensuring the smooth operation of our clinical services.

Key Responsibilities
  • Create and manage batch files for Connects
  • Retrieve and process response files from Beacon's SFTP site
  • Work with Connects documents to ensure accurate and timely processing
  • Manage and process BHL CSU authorizations and update Carelogic
  • Review and process the AC file for BHL CSU authorization
  • Complete the State Discharge process for Fulton locations
  • Create PTRF referrals via Beacon authorization requests
  • Review and process Connects documents in UM review
  • Run reports on service delivery, service history, and failed claims
  • Manage Carelogic client discharge processes
  • Review client records and create discharge connects and summaries
Requirements
  • High School Diploma (Bachelor's degree in a related field preferred)
  • 1-3 years of experience in utilization management
  • Attention to detail and ability to work well under pressure
  • Effective time management skills
What We Offer
  • Competitive pay and benefits package
  • Medical, dental, and vision insurance
  • Paid time off and 12 paid holidays
  • 401(k) with employer match
  • Flexible spending accounts
  • Short and long-term disability coverage
  • Life insurance
  • Employee discount program


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