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UM Clinical Services Coordinator, ABA - West Region in Cypress, CA at Beacon Health Options

Date Posted: 3/19/2019

Job Snapshot

Job Description

About the Position:

We are currently seeking a dynamic ABA Clinical Care Coordinator to join our Utilization Management team in Cypress, CA! The ABA Clinical Care Coordinators serves as central point of contact and communication for members, families, providers, insurers and members of the ABA team in the linkage of care for Applied Behavioral Analysis (ABA) services.  Addresses a broad spectrum of needs and/or concerns in a professional, friendly, and efficient manner. Performs a variety of customer service and unit-operations activities to assist clinical and administrative staff to meet operational and business performance metrics.

Position Responsibilities:

  • Assist members and providers with all levels of inquiries, problem solving, insurance information and general customer service, which could include:
    • Customer material requests and member registration
    • Benefit and Eligibility information
    • Physician assignments
    • Authorization for treatment
    • Billing and Payment issues
    • Explanation of Benefits (EOB)/Explanation of Payments (EOP)
    • Clinical Care Management system usage
  • Staff all Call Center queues and adhere to performance requirements for call center response times, abandonment rates, and other productivity, schedule, and quality standards or metrics that may be established.
  • Receive, respond and resolve questions about accessing ABA services.
  • Analyze data and identify appropriate level of care to expedite linkage to care to ABA services. 
  • Gather required clinical and financial information care for members and enter data into clinical care management system.
  • Monitor the data in the clinical care management system, collaborating with provider community; escalate issues and concerns regarding care management to Senior Care Managers according to policies and procedures.
  • Act as a liaison with parents and the health community to ensure continuum of care and support for members.
  • Participates in corporate quality improvement functions. 
  • Assists with special projects and administrative tasks as assigned. 
  • Performs other duties as required.

Position Requirements:

  • Education: High School diploma or GED equivalent required
  • Relevant Work Experience: 5 years’ general working experience with 2 years’ of Customer Services experience required
  • Knowledge, Skills, & Abilities:
    • Previous experience in a call center environment within the healthcare preferred
    • Knowledge or ability to learn state and federal laws and regulations applicable to the call center
    • Must have strong analytical, problem solving and organizational skills
    • Outstanding interpersonal skills needed to frequently interact with members, families, providers and insurance representatives to address a variety of concerns and requests
    • General knowledge of Microsoft Office Suite: Outlook, Excel, and Word
    • General knowledge of clinical documentation, preferably electronic health records/medical records systems
    • Must possess high-level written and verbal skills
    • Ability to learn, master, and incorporate use of variety of clinical and administrative automated systems and software into daily work.
    • Bilingual in English and Spanish preferred

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