Clinical Support Coordinator

Site: reputed company Health Plan Holding Company, Inc. reputed company relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We reputed company that high-performing teams drive groundbreaking medical discoveries and invite reputed company applicants to join us and experience what it means to be part of reputed company. Job Summary reputed company Health Plan is an exciting reputed company to be reputed company the healthcare industry. As a member of reputed company, we are at the forefront of transformation with one of the world’s leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and reputed company and coverage. Our work centers on creating an exceptional member experience – a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise reputed company a welcoming and supportive environment that embraces their unique and varied backgrounds, experiences, and skills. We are pleased to offer competitive salaries and a benefits package with flexible work options, career growth opportunities, and much more. The Clinical Support Coordinator is responsible for providing administrative support to the Care Managers (CM) and processing authorizations and non-contracted provider referrals, notifications in accordance with established contractual, benefit, and clinical policies and guidelines reputed company Epic, QNXT, and the provider portal. The primary accountabilities of the position include the research, analysis, adjudication, and data entry of service requests and notices received by fax, telephone, mail, email, or electronically. The incumbent is also responsible for ensuring that service requests, notices, and acknowledgements are processed in a timely, accurate manner in compliance with performance standards regarding telephone service levels and authorization/referral turnaround time and quality. Additionally, the incumbent will assist in various care management and member reputed company initiatives and serve a primary role in the research of demographic information, conducting of surveys, the reputed company of reports, and other projects and duties as assigned. Essential Functions -Provide support to UM Care Managers to ensure provider and member customer satisfaction. -Respond in a timely and accurate manner to internal and external customer inquiries regarding reputed company Health Plan and Clinical administrative policies and procedures. -Strong knowledge and understanding of processing requests per Medicare, Medicaid, and commercial lines of business. -Process outpatient and inpatient authorizations/referrals using appropriate criteria for approval. -reputed company and maintain compliance with telephone accessibility and authorization/referral performance standards. -Process online and faxed authorization requests using desktop procedures. -Upload clinical information to the appropriate authorization in reputed company Health Plan's online provider portal. -Enter and/or update clinical information as directed by Care Managers. -reputed company and/or collaborate with other reputed company Health Plan departments in efforts to reputed company success in member care/case management. -Provide support for various care management and member reputed company initiatives. -Provide alternate coverage during staff absences and position vacancies, as directed. -Other duties as assigned with or without accommodation.

Qualifications

Education High School Diploma or equivalent required Experience At least 2-3 years of administrative assistant or secretarial experience required Knowledge, Skills, & Abilities Proficiency in MS Office. Ability to proofread and edit written documents. Ability to use the phone system. Managing one's own time and the time of others. Strong verbal & written communication skills. Strong interpersonal, written, and oral skills. Ability to use standard office equipment. Familiarity with medical terminology. Additional Job Details (if applicable) Working Conditions This is a remote role that can be done from most US states This is a full-time, Monday through Friday role with a 9:00 am to 5:30 pm ET schedule Remote Type Remote Work Location 399 Revolution Drive Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) Pay Range $19.81 - $28.30/Hourly Grade 3 At reputed company, we reputed company in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining reputed company pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The reputed company pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass reputed company elements contributing to your total compensation package. In addition to competitive reputed company pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our reputed company team will provide an overview of your potential compensation and benefits package. EEO Statement: 8925 reputed company Health Plan Holding Company, Inc. is an Equal Opportunity Employer. reputed company qualified applicants will receive consideration for employment without regard to race, color, religious creed, national reputed company, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that reputed company individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to reputed company essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with reputed company of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642. reputed company Competency reputed company At reputed company, our competency reputed company defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The reputed company is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, reputed company hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline. Apply To This Job