Benefits Determination Unit Coordinator

Job not on LinkedIn

🔥 8 minutes ago

🇺🇸 United States – Remote

💵 $19 - $22 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 0%

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Lucet

WebsiteLinkedInAll Job Openings

501 - 1000 employees

🏥 Healthcare

⚕️ Healthcare Insurance

☁️ SaaS

Healthcare • Healthcare Insurance • SaaS

Lucet is a tech-enabled behavioral health company that combines human care teams and digital tools to connect individuals to timely, in-network mental health and substance-use care. It partners with health plans, employers, providers, and members through portals (employer/HR, member, provider, partner) and services such as EAP, care navigation, and provider resources to optimize access, quality, and value-driven behavioral healthcare.

📋 Description

• Provide administrative and operational support for the Benefits Determination Unit • Coordinate peer-to-peer reviews, physician reviews, and Medical Director consultations • Manage scheduling, tracking, reviewer availability, credentials, and related records • Support benefit determination activities, including review coordination, documentation, communications, escalations, reporting, meeting support, and case assignments • Track time-sensitive review activities and support adverse benefit determination, expedited appeal, retrospective review, and related utilization management workflows • Support regulatory, accreditation, contractual, and organizational compliance requirements • Maintain accurate documentation and protect confidential information • Assist with audits and reporting activities • Escalate workflow or compliance risks • Contribute to process improvement initiatives and ensure timely, efficient workflow management

🎯 Requirements

• Bachelor’s level degree with two years of relevant experience in a health care, managed care and/or customer service setting, or high school diploma (or equivalent) and five years of relevant experience in such a setting • Equivalent combination of education and experience will be considered • Strong organizational, written, and verbal communication skills • Professional demeanor and ability to work collaboratively with multiple levels of professionals and line staff internally and externally • Highly motivated, detail oriented, and able to take initiative and work independently as well as with a team • Strong interactive/interpersonal skills • Advanced skills with MS Office Suite, including ability to document while simultaneously taking information over the phone • Ability to identify issues, follow established processes, escalate concerns appropriately, and support timely completion of assigned work • Ability to be flexible, manage multiple priorities, and meet deadlines • Ability to maintain confidentiality and handle sensitive health care information appropriately • Ability to pass background check upon hire and throughout employment, including criminal, identity, education, employment, sanctions, prohibited parties, and drug-screen checks • High-speed internet service with minimum download speed of 20 Mbps, upload speed of 5 Mbps, and maximum latency of 100 milliseconds, installed before starting • Quiet workspace with minimal background noise for calls • Ability to remain stationary and seated for extended periods, communicate and exchange information, inspect information, perform repetitive motions, interpret data, problem solve, make decisions, organize and plan, and maintain a positive and professional attitude

🏖️ Benefits

• Annual performance-based, discretionary incentive • Medical, dental, and vision coverage • 401(k) with competitive employer match • Company-paid life and disability insurance • Paid parental leave and wellbeing incentives • Generous paid time off, including volunteer time • Flexible spending accounts for healthcare and dependent care • Professional development opportunities and tuition reimbursement • Remote work flexibility (role-dependent) • Company-provided equipment • Opportunity for meaningful personal and professional growth