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UM Clinical Support Specialist - Northeast Region in Boston, MA at Beacon Health Options

Date Posted: 4/11/2019

Job Snapshot

Job Description

About the Position:

We are currently seeking a dynamic UM Clinical Intake Support Specialist to join our growing Utilization Management team at our office in Boston, MA! The Intake Specialist will provide administrative support a staff of behavioral health clinicians on the 24 hour Clinical Access Line. The Clinical Intake Specialist will triage telephone calls by collecting sufficient data to direct calls and make appropriate referrals, seeks consultation with clinical staff for callers with multiple routine needs, enters authorizations to facilitate claims payment and when a medical necessity determination has already been made or when Medical Necessity determination is not necessary. The Clinical Intake Specialist will also update and track changes to departmental reports, act as liaison for remote employees regarding call queues, and help troubleshoot and resolve facility and technology related issues.

Position Responsibilities:

  • Distribute and accurate boarding report three (3) times daily, maintain mailbox and distribution lists, make follow-up call, update queues, communicate with regional teams and clinical management
  • Generate daily and weekly reports and complete miscellaneous tasks (Access Line Data reports)
  • Complete telephone assessments and referrals for Members
  • Triage and manage Department calls by  gathering demographics and information as necessary and placing in a task list, to facilitate timely call backs from clinicians 
  • Manage the Expedited authorization website to ensure submissions are responded to in a timely manner. 
  • Assist with any reporting activities via data requests by management staff
  • Manage queues in Care Connect and Flexcare operating systems, including checking inquiries and updates for accuracy
  • Answer all Crisis calls immediately and warm transfer distressed Members to a Clinician
  • Maintain departmental productivity and performance standards
  • Provide daily administrative support as assigned by the Director of the Access Line
  • Manage Department faxes and build authorizations for initial CSP requests
  • Maintain and update as needed the Department Sharepoint wite with all references, procedures, and protocols
  • Process clinical appeals and denials working with clinical staff to ensure company policy and turnaround times are met

Position Requirements:

  • Education: Bachelor’s degree in healthcare or related field required
  • Relevant Work Experience: 1 - 2 years’ experience working in a call center or healthcare filed required
  • Knowledge, Skills, & Abilities:
    • Ability to provide excellent customer service with great communication skill
    • Ability to multitask and remain oprganized
    • Ability to communicate with potentially distressed Members on the phone
    • Ability to make appropriate decisions about when to involve a Care Manager or Clinical Manager for assistance

To Apply:

Click below on “Apply for this Position” to create a profile and apply for the position.

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

At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you.

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