Job Description

Job Title: Clinical Administrative Coordinator
Pay Rate: $20/hour
Job Type: Full-Time
Schedule: Monday–Friday | 9:30 AM – 6:00 PM
Work Environment: Remote / Telecommute
Contract to Hire: 01/12/2026 to 06/30/2026

Position Overview

The Clinical Administrative Coordinator supports Behavioral Health and Substance Use Disorder Utilization Management by validating eligibility, preparing authorization requests, managing documentation, and ensuring accurate communication with providers and members. This role requires strong attention to detail, excellent communication skills, and the ability to apply clinical knowledge to authorization guidelines. The coordinator also assists with escalated calls, maintains confidentiality, and supports internal teams with accurate documentation and workflow management.

Key Responsibilities

• Verify eligibility for all provider and member authorization requests

• Enter and prepare Behavioral Health and Substance Use Disorder authorizations for multiple lines of business

• Refer members to Care Coordination for aftercare planning support

• Notify providers of authorization determinations

• Facilitate peer-to-peer consultation offers when cases do not meet criteria

• Draft denial letters outlining decisions and alternative treatment options

• Assist callers routed to the Behavioral Health UM department

• Complete required training (e.g., MCG, ASAM, InterQual)

• Manage incomplete authorization requests and gather missing information

• Take detailed meeting notes and distribute to appropriate teams

• Provide benefit, safety, and coverage information to providers and consumers

• Maintain strict confidentiality of PHI

• Handle escalated calls and resolve complex issues

• Upload and verify Release of Information documentation

• Organize and track authorization requests

• Ensure use of the most up-to-date member handbook guidelines

• Support audit preparation by creating bookmarks and correcting report errors

• Enter Single Case Agreements into the EHR and notify appropriate teams

• Maintain and update job aids

• Perform additional duties as assigned

Required Qualifications

• High School Diploma or GED

• 2+ years of experience analyzing and resolving customer issues

• 2+ years of experience in the healthcare industry

• 2+ years working with medical or behavioral health terminology

• Intermediate computer proficiency (EHR navigation, email, online research, data entry)

• Ability to work a Mountain Time schedule

• A quiet, secure home workspace suitable for handling PHI

• Residency in the United States

• Ability to obtain or maintain a company-approved high-speed internet connection

Preferred Qualifications

• 6+ months of experience with electronic medical records (EMR)

• Experience in the Colorado healthcare market

• Previous remote work experience

• Prior data entry experience

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