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Clinical Operations Specialist

Behavioral Health Group Lexington, KY
  • Posted: over a month ago
  • Other

Behavioral Health Group (BHG), a leading provider of opioid addiction treatment services. BHG provides medication assisted treatment and counseling services in a conventional outpatient setting.

At BHG, we are committed to the belief that addiction is a brain disease, not a moral failing. We are committed to treatment that embodies Hope, Respect, and Caring.


Summary of Essential Job Functions

  • Demonstrates a high level of technical competence in the provision of clinical substance abuse treatment services
  • Supports the Director of Clinical Affairs and Regional Directors in the evaluation, expansion and implementation of clinical services in their assigned regions
  • Work closely with RCM, Operations and Clinical Affairs departments to tailor clinical programming to be in alignment with best practices within what third party payers pay for in their local environment
  • Supports the Operations and Clinical Affairs in overseeing retrospective, concurrent or prospective clinical and medical chart audits and collaborates with Revenue Cycle Management leadership to assure that CPT codes billed are appropriate and supported by documentation in the patient record and proper clinical utilization is occurring
  • Supports the company’s monthly chart and claims audit activities related to third party payers, including development and administration, action planning and follow up to ensure resolution of identified documentation deficiencies
  • Proactively identities gaps and risks in clinical services documentation and supports implementation of needed corrective actions in a timely manner
  • Identifies and makes recommendations for process improvement opportunities
  • Understands the clinical documentation requirements for State, Federal, Joint Commission, and third-party payers in their assigned regions
  • Supports the clinical initiatives of the organization with planning, organizing and coordinating initiatives to ensure the standardization of best practices for BHG’s clinical operations
  • Works closely with the Regional Directors and Program Directors to assist in regional initiatives as determined by the SVP of Regulatory and Clinical Affairs and the Director of Clinical Affairs

General Regulatory and Compliance

  • Holds an advanced level of understanding of alcohol/drug abuse and addiction
  • Complies with all federal, state, local, regulatory and third party agency requirements
  • Complies with all accrediting agencies

Professionalism

  • Demonstrates the belief that that addiction is a brain disease, not a moral failing
  • Demonstrates hope, respect and caring in all interactions with fellow Team Members
  • Establishes and maintains positive relationships within the workplace
  • Can work independently and under pressure while handling multiple tasks simultaneously
  • Makes decisions and uses good judgment with confidential and sensitive issues

Training

  • Participate in all trainings as required by federal, state, local and accrediting agencies.
  • Attend conferences, meetings, and training programs as directed.
  • Participate in and/or schedule and attend regular in-service trainings within and outside local BHG Treatment Centers

Minimum Requirements

Counseling license or certification preferred, other candidates with 2 or more years of clinical auditing experience will be considered.

  • High integrity
  • Excellent verbal and written communication skills
  • Sound judgment
  • Efficient
  • Self-starter
  • Strong customer service and interpersonal communication skills
  • Knowledge of basic accounting and accounts receivable
  • Ability to work independently and under pressure handling multiple tasks simultaneously
  • Ability to enforce treatment center policies with regard to fee collection as applicable
  • Must be able to react quickly
  • Demonstrate basic knowledge and skill of office equipment and software
  • Ability to make decisions and use proper judgment with confidential and sensitive issues
  • Ability to deal appropriately with patient and team members in stressful or challenging situations and seek direction from supervisor when necessary
  • Ability to demonstrate sufficient knowledge and understanding of human behavior to show potential rehabilitating drug dependent patients
  • Must have sufficient knowledge of the substance abuse population, treatment planning and field of human and social services to work toward the rehabilitation of the patient
  • Must have sufficient working knowledge of available community resources and be able to generate a workingrelationshipwithcommunityresources,includingbutnotlimitedto:
    • Other treatment providers in the area
    • Federal, state, and other local social service

Behavioral Health Group

Behavioral Health Group (BHG), a leading provider of opioid addiction treatment services. BHG provides medication assisted treatment and counseling services in a conventional outpatient setting. At BHG, we are committed to the belief that addiction is a brain disease, not a moral failing. We are committed to treatment that embodies Hope, Respect, and Caring.

Address

Lexington, KY
40504 USA

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