| Location | Macon, GA |
Utilization Management Coordinator
Company Overview:At River Edge Behavioral Health in Macon, GA, employees are expected to develop meaningful relationships with patients, establishing trust and making a difference in the lives of clients and their families. We believe in supporting our team as well as our clients with our comprehensive benefits package and a supportive work culture, including health, dental, and vision benefits, paid vacation, retirement plans, and more.
Position Overview:The Utilization Management Coordinator role is focused on ensuring clients receive the appropriate level of behavioral health care while maintaining compliance with medical necessity, authorization, and documentation requirements. The position combines utilization review, care coordination, insurance authorization management, and administrative oversight within behavioral health services.
Location/Schedule:3575 Fulton Mill Road, Macon, GA.
Key Responsibilities
Create Connects batch files
Retrieve and process response files from Beacon's SFTP site
Work Connects documents in rejected, denied, hold, no CID, multi-final payer and status appropriately
Review discharge connects and flip to UM complete
Manage and process BHL CSU authorizations and update Carelogic
Review and process AC file for BHL CSU authorization
Complete State Discharge process for Fulton locations
Create PTRF referral via Beacon authorization request
Review and process Connects documents in UM review
Qualifications
High School Diploma (Bachelors in helping profession such as social work, community counseling, counseling psychology, or criminology preferred)
1-3 years of utilization management experience
Additional Benefits:
Flexible spending accounts11 Paid holidays
Voluntary Life Insurance