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Behavioral Health Coordinator

Kelly Services

Richardson, TX
Job Code:
  • Healthcare
  • Coordinators
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Job Details

Job Title Behavioral Health Coordinator

Jobid US586KTH_BH1429517

Location: Richardson, TX, 75081, USA

Description Behavioral Health Coordinator (Appeals, Non-Clinical)

TYPE: Temporary/Contract – about 60 days

Hours: Monday through Friday, 8:00 a.m. to 5:00 p.m.

Location: HCSC/BCBS, 1001 E. Lookout Drive, Richardson, TX 75082

Under supervision, this position is responsible for providing support to members and physicians in the processing of Behavioral Health clinical appeals/grievances including responding to inquiries, conducting outbound calls, scheduling appointments, conducting research, performing data entry, resolving problems by working across departments, and supporting the behavioral health appeals department.
1. Receive and respond to customer or physician inquiries. Process information from member or provider to determine needs/wants and ensure customer questions have been addressed. Respond to customer or send to appropriate internal party.
2. Perform outreach to members and/or physicians as needed to provide assistance or schedule appointments.
3. Generate or compose appropriate correspondence and send to members manually or electronically.
4. Maintain production requirements based on established department business needs.
5. Provide support to the clinical team by performing the non-clinical functions necessary to generate and close a case within the platform.
6. Facilitate scheduling clinical reviews with medical directors/physician reviewers, including shaping request, initial peer reviews, post service reviews, appeals and other reviews requiring physician review.
7. Responsible for building appeals through system integration including dashboard, the Enterprise Appeal Application, and the Enterprise Content Management System.
8. Research next level of appeal and communicate information to the member, provider, and facility when applicable.
9. Facilitate verbal and written communication of the initial peer review determination to the member, provider, and facility when applicable including any unable to reach communication.
10. Responsible for uploading clinical data to any external review organization to facilitate peer review completion within state and regulatory guidelines.
11. Responsible for documenting peer review outcomes in the medical management system.
12. Responsible for uploading manual determination letters and member communications to the Enterprise Content Management System.
13. Assign and delegate work items received via email and/or medical management system.
14. Communicate and interact effectively and professionally with co-workers, management, customers, etc.
15. Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.
16. Maintain complete confidentiality of company business.
17. Maintain communication with management regarding development within areas of assigned responsibilities and perform special projects as required or requested.

* 1 year of college and 2 years of experience with automated systems OR 3 years of experience with automated systems.
* Experience coordinating member needs, providing assistance to members, and analyzing member needs.
* Knowledge of medical terminology.
* Database experience or PC applications experience.
* Customer service skills.
* Verbal and written communications skills including interpersonal skills to assist members and coordinate care with physician offices, developing written correspondence to members and to other department personnel, and to support departmental personnel and functions.

**Why Kelly** **®** **?**

At KellyServices ® , we work with the best. Our clients include 95 of the Fortune100 ™ companies, and more than 70,000 hiring managers rely on Kelly annually to accessthe best talent to drive their business forward. If you only make one career connection today, connectwith Kelly.

**AboutKelly Services** **®**

As a workforce advocate for over 70 years, we are proud to directly employ nearly 500,000 peoplearound the world and have a role in connecting thousands more with work through our global network oftalent suppliers and partners. Revenue in 2017 was $5.4 billion. Visit and connect with us on Facebook, LinkedIn and Twitter .

Kelly Services is an equal opportunity employer including, but not limited to, Minorities, Females,Individuals with Disabilities, Protected Veterans, Sexual Orientation, Gender Identity and iscommitted to employing a diverse workforce. Equal Employment Opportunityis The Law.

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