Do you have your Bachelor's degree in social work or realted field and looking to get a rewarding position with large managed care company in Eden Praire? This is the job for you! We have opening for a Behavioral Health Support Team Coordinator. Please apply with updated resume to set up a phone inteview today!
- Create and process Administrative and Medical Necessity determination denial letters to facilities and members ensuring accuracy with documentation and compliancy with state and federal guidelines for multiple lines of business including CAMS, TruCare, CCMS, and QANI.
- Partner with internal matrix teams to ensure legal, Federal and State Mandates are in compliance and NCQA & URAC accreditation guidelines are met.
- Responsible for tracking and sending Lack of Information letter requests.
- Utilize Excel, Daily Stats, and Sharepoint site to create and send out morning report, which details case assignment and caseloads for case managers.
- Complete monthly reporting and stats.
- In control of managing the precert bin and assigning cases to case managers and care coordinators in an expeditious manner.
- Accountable for the TruCare provider add process.
- Integrate with other Care Coordinator teams to support and reinforce the day to day needs.
- Call Center Environment - Taking phone calls
- crisis intervention (2 years of experience is required)
- Bachelors Degree (1 year of experience is required)
- Call Center Support (3 years of experience is required)
- appeals (1 year of experience is preferred)
- behavioral health office (2 years of experience is required)
- Years of experience: 2 years
- Experience level:Entry Level
Working hours: 10:30 AM - 7 PM
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