Coordinator, Benefits Determination Unit (BDU)

Lucet; United States; À distance; USD 26 000 - 30 000; Plein temps

Avantages offerts par ce poste

Health benefits

401(k) with employer match

Paid parental leave

Remote work

Résumé du poste

Lucet is seeking a Coordinator, Benefits Determination Unit to support scheduling of peer-to-peer and physician reviews, documentation, and timely benefit determinations. You will provide operational and administrative support, coordinate reviewer availability, ensure compliance, and help manage sensitive health information.

This is a remote role performed from home with company-provided equipment, requiring strong organization and the ability to juggle multiple priorities in a fast-paced,

Qualifications

• Bachelor’s degree with 2 years of relevant health care experience, or high school diploma with 5 years experience.
• Strong organizational, written and verbal communication skills.
• Professional demeanor; ability to collaborate across levels.

Responsabilités

• Coordinate and manage scheduling of peer-to-peer reviews, physician reviews, and Medical Director consultations.
• Provide operational and administrative support for benefit determination activities, including review coordination, documentation, tracking, communications, escalations, reporting, meeting support, case assignments, and process improvement.
• Maintain documentation, assist audits, and escalate workflow or compliance risks.

Connaissances

Organizational skills

Written communication

Verbal communication

Professional demeanor

Collaborative

MS Office

Formation

Bachelor’s degree + 2 years healthcare experience

High school diploma + 5 years healthcare experience

Outils

MS Office Suite

Description du poste

Who We Are

At Lucet, we’re transforming whole-person care. We deliver integrated behavioral and physical health solutions that connect individuals to the right care at the right time—improving outcomes and overall well-being. Serving over 15 million lives across the U.S. and Puerto Rico, our model combines clinical expertise, compassionate care, and innovative technology to support healthier, more fulfilling lives.

As part of the Lucet team, employees join a mission-driven organization committed to making a lasting impact. Whether through behavioral health navigation, in-home medical care, or 24/7 crisis support, our work is rooted in empathy, collaboration, and a shared passion for helping people thrive.

Why Join our Team

At Lucet, we’re committed to creating a workplace where top talent thrives both personally and professionally. We offer a dynamic, mission-driven environment where your work has real impact, your unique background and experience are valued, and no two days are alike.

We support our team with a competitive compensation and benefits package, including:

• Hourly compensation between $19.50-22.00/hr, PLUS an annual performance-based, discretionary incentive.
• Compensation is dependent on non-discriminatory factors including but not limited to an applicant's skills, education/degrees, certifications, prior experience, market data, and other relevant factors.
• Comprehensive health benefit options: 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)
• Opportunity for meaningful growth, both personally and professionally, where your unique background and experience is welcomed and valued.

What You Will Do - Essential Functions

The Coordinator, Benefits Determination Unit (BDU) provides administrative and operational support for the Benefits Determination Unit, including coordination of peer-to-peer reviews, physician review scheduling, documentation support, tracking of time-sensitive review activities, and general support of adverse benefit determination, expedited appeal, retrospective review, and related utilization management workflows.

• Clinical Review Scheduling and Coordination
  • Coordinate and manage the scheduling, tracking, and administrative support of peer-to-peer reviews, physician reviews, and Medical Director consultations while maintaining reviewer availability, credentials, and related records.
• Administrative Support
  • Provide operational and administrative support for benefit determination activities, including review coordination, documentation, tracking, communications, escalations, reporting, meeting support, case assignments, and process improvement initiatives to ensure timely and efficient workflow management.
• Quality, Compliance, and Documentation
  • Support compliance with regulatory, accreditation, contractual, and organizational requirements by maintaining accurate documentation, protecting confidential information, assisting with audits and reporting activities, and escalating identified workflow or compliance risks

Who You Are

• Required Qualifications
  • 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 a health care, managed care and/or customer service 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 with the ability to take initiative and work independently as well as with a team
  • Strong interactive/interpersonal skills
  • Advanced skills with MS Office Suite, including the ability to document while simultaneously while taking information over the phone
  • Ability to identify issues, follow established processes, escalation 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 to include criminal felony & misdemeanor search, SSN validation/trace search (LEIE), education report (highest degree obtained), civil upper and lower search, 7-year employment report, federal criminal search, statewide criminal search, widescreen plus national criminal search, health care sanctions-state med (SAM), national sex offender registry, prohibited parties (OFAC) (terrorist watchlist), and a 10-Panel Drug Screen.

Living Our Values

• Serving everyone with compassion and leading with empathy.
• Stepping up and creating value by taking charge and acting when there is an opportunity.
• Adapting in a changing world by recognizing our responsibility to be agile and respond quickly.
• Nurturing growth and belonging by respecting and celebrating everyone for who they are.

Competencies

• Strong attention to detail and commitment to accuracy.
• Ability to manage multiple tasks and competing priorities in a fast-paced environment.
• Professional demeanor and ability to communicate effectively with internal and external stakeholders regardless of the nature or circumstances of the situation.
• Sound judgment in identifying when to elevate issues, risks, or time-sensitive concerns.

Working Conditions

• High-speed internet service (cable or fiber optic) with minimum download Speed of 20 Mbps, Upload Speed of 5 Mbps, and Maximum Latency of 100 milliseconds (must be installed before starting) required.
• Frequent use of computer and phone systems
• Must be able to constantly remain in a stationary, sitting position, communicate and exchange information with others, inspect information, perform repetitive motions with arms and fingers, interpret data, problem solve, make decisions, organize and plan, and maintain a positive and professional attitude in all situations.
• Work is performed from home with company-provided equipment. Sitting for long periods of time is expected and use of fingers and hands for typing is necessary.
• A quiet workspace with minimal background noise for calls.

This position will accept and review new applications and resumes no less than 5 business days after the original posting date and may remain open an extended period of time with no set end date based on the level of interest.