Behavioral Health Specialist

Job Summary

A company is looking for a Behavioral Health Specialist responsible for managing prior authorization and inpatient admission requests for behavioral health services.

Key Responsibilities

• Manage and prioritize incoming behavioral health authorization and inpatient admission requests while ensuring compliance with departmental protocols
• Verify member eligibility and accurately enter data into the Jiva system to maintain turnaround time standards
• Communicate with healthcare providers to gather necessary clinical information for authorization determinations and resolve escalated inquiries

Required Qualifications

• Associate's Degree in Healthcare, Nursing, Social Work, or a related area, or equivalent training and experience
• Minimum of 2 years of experience in a high-volume healthcare office, hospital administration, data entry, or customer service call center
• Knowledge of medical terminology is preferred
• Familiarity with Jiva, FACETS, or other healthcare databases is desirable
• Pre-employment background check is required