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We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with Blue Cross.

Residency in or relocation to Louisiana is preferred for all positions.

POSITION PURPOSE

The Behavioral Health Coordinator provides administrative support throughout Louisiana Blue’s behavioral health authorization process. This includes answering phone calls routed to Behavioral Health Utilization Management, monitoring work queues within Epic, Enterprise Workflow, and fax systems. Authorized to enter specific types of authorizations and will call members and providers to obtain additional information for requests and to notify of approvals. Will provide other types of non-clinical support to the Behavioral Health Department.

How You Contribute to the Company’s Mission In This Role

+ Answers incoming phone calls regarding authorization requests and initiates processing of the request or routes to appropriate Utilization Review staff. Provides member/provider notification of authorization approvals and guidance for non-clinical questions regarding authorizations, such as where to locate the pre-authorization form on Blue Cross Blue Shield of Louisiana’s website and assists with provider requests for emailing or faxing the pre-authorization form.

+ Assists with collection of data and enters pre-authorizations in Epic or other data systems under the supervision of appropriately licensed health professionals. This may include demographic information (e.g. patient’s name, date of birth, ordering physician, where services are to be performed, date of service, etc.) Approves services based on set criteria where no clinical judgment is required.

+ Assists with the preparation and distribution of written notifications for authorization decisions made by the Behavioral Health Department. Reviews correspondence for errors prior to sending.

+ Assists with timely processing and distribution of incoming faxes, emails and phone requests for behavioral health authorizations. This includes US postal mail delivery, external faxes, personal delivery, internal emails, and web-based portals.

+ Research databases and systems such as Acuity, VNET, QNXT, Facets, Epic, and other systems to determine if incoming requests are duplications of existing authorizations or new requests, forwarding misrouted request to the appropriate departments, and initiating workflow to the appropriate persons within the department

+ Appropriate labeling and identifying time/date of receipt of authorization requests along with the processing priority (standard or expedited) for each incoming request

+ Assists with the routine review of daily error reports to identify and correct data entry errors.

+ Other duties as assigned

Required Qualifications

+ High school diploma or equivalent

+ 1 year of customer service or medical office experience required

+ Proficient in Microsoft Office Suite (Excel, Word, Power Point, etc.)

+ Highly organized and efficient with strong attention to detail

+ Ability to multitask and prioritize in a fast-paced, ever-evolving environment

+ Excellent verbal and written communication skills

+ Ability to interact effectively with all levels of staff

Preferred Qualifications

+ Previous experience in a healthcare or insurance setting

+ Medical terminology knowledge

+ Previous experience dealing with utilization management

+ Ability to type minimum of 40 WPM

_The Physical Demands described here are representative of those that must be met by an employee to successfully perform the Accountabilities and Essential Functions of the job. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions_

+ Perform other job-related duties as assigned, within your scope of responsibilities.

+ Job duties are performed in a normal and clean office environment with normal noise levels.

+ Work is predominately done while standing or sitting.

+ The ability to comprehend, document, calculate, visualize, and analyze are required.

\#LI_MS1

An Equal Opportunity Employer

All BCBSLA EMPLOYEES please apply through Workday Careers.

PLEASE USE A WEB BROWSER OTHER THAN INTERNET EXPLORER IF YOU ENCOUNTER ISSUES (CHROME, FIREFOX, SAFARI)

Additional Information

Please be sure to monitor your email frequently for communications you may receive during the recruiting process. Due to the high volume of applications we receive, only those most qualified will be contacted. To monitor the status of your application, please visit the "My Applications" section in the Candidate Home section of your Workday account.

If you are an individual with a disability and require a reasonable accommodation to complete an application, please contact [email protected] for assistance.

In support of our mission to improve the health and lives of Louisianians, Blue Cross encourages the good health of its employees and visitors. We want to ensure that our employees have a work environment that will optimize personal health and well-being. Due to the acknowledged hazards from exposure to environmental tobacco smoke, and in order to promote good health, our company properties are smoke and tobacco free.

_Blue Cross and Blue Shield of Louisiana performs background and pre-employment drug screening after an offer has been extended and prior to hire for all positions. As part of this process records may be verified and information checked with agencies including but not limited to the Social Security Administration, criminal courts, federal, state, and county repositories of criminal records, Department of Motor Vehicles and credit bureaus. Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner._

_Additionally, Blue Cross and Blue Shield of Louisiana is a Drug Free Workplace. A pre-employment drug screen will be required and any offer is contingent upon satisfactory drug testing results._

JOB CATEGORY:** **Healthcare/Pharmacy Services