PEER ADVISOR CLIENT SVCS COORD in Reston, VA at Beacon Health Options

Date Posted: 5/11/2018

Job Snapshot

Job Description

ABOUT THE POSITION

We are currently seeking a dynamic Peer Advisor Client Services Coordinator to join our team at our office in Reston, VA.  The Peer Advisor Client Services Coordinator will be responsible for ensuring that National Peer Advisor reviews, assessments, and billing are efficiently administered according to multiple contractual requirements on a daily basis. This includes responsibility for creating accurate Peer Advisor records and communicating results with clients, providers and members through written and verbal communication.  Responsible for the upkeep and maintenance Peer Advisor personnel files.

Position Responsibilities:

  • Provides client account management to assure contractually appropriate criteria is utilized for Peer Reviews, accurate billing/invoicing is maintained, and service issues are addressed in a timely manner with each issue the client brings to his/her attention.
  • Creates the clinical review in the system as requested by the outside client then forwards to Peer Advisor who is scheduled to conduct the review.  Audits Peer Advisors decisions to ensure that vendor requirements are met, and all elements of the request are addressed before communicating the result back to the client.
  • Responsible for taking National calls on an ACD line from providers and members concerning Peer Review cases. Independently assesses each call to ensure that client questions/concerns have been addressed and appropriate internal/external actions are taken to guarantee issues are solved in a timely manner.    Responds to 14 ACD or External call outs per day, when fully staffed.
  • Administer invoices, tracking and billing for all Beacon Peer Advisors. Ensures appropriate data entry and billing by Peer Advisors occurs for external client business and reports any discrepancies to the Manager of Peer Advisor Services.
  • Create addendums to PA reviews in Manager’s absence. 
  • May support the generation of detailed adverse determination and appeal determination letters conforming to regulatory, accreditation, and contractual standards of the client, and may also provide weekend support.
  • Supports the credentialing and re-credentialing of Peer Advisors and Medical Directors.  Enters Peer Advisor information into the National Network Connect. This includes: Agreements, licensure, credentialing primary source verification and training.   Maintains PA list and files including monitoring of license renewals.
  • Support development testing for clinical programs to ensure the integrity of the PA screens are not affect by changes.
  • Performs other duties and works on special projects as assigned.

Position Requirements:

Education: Bachelor’s degree in psychology, social work or other behavioral health discipline is required.  Two (2) years’ experience in Beacon Health Options Peer Advisor Service Department may be substituted for the Bachelor’s degree requirement.

Licensure:  N/A

Relevant Work Experience:   At least two years of experience working in a hospital, psychiatric facility or medical office environment required.  Requires a strong understanding of medical terminology. 

Knowledge, Skills & Abilities:

  • Expert MS Word, Excel Outlook proficiency and Basic PowerPoint and Project proficiency  
  • Analysis and problem solving skills (Intermediate)
  • Interpersonal communication skills (Expert)
  • Verbal and written communication skills (Expert)
  • Group presentation and public speaking skills (Basic)
  • Collaboration and team-oriented work philosophy skills (Expert)
  • Must be well organized, have solid computer skill sets, with the ability to function independently.

TO APPLY

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Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled

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