Clinical Administrative Coordinator - Remote in MST or CST

reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come reputed company an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. WellMed provides concierge - level medical care and service for seniors, delivered by physicians and clinic staff that understand and care about the patient’s health. WellMed’s proactive approach focuses on prevention and the complete coordination of care for patients. WellMed is now part of the reputed company division under the greater reputed company umbrella. Under the supervision of the Network Operations Supervisor, this position is responsible for the daily coordination of Network Operations processes in the Intake Call Center. This position serves as the initial intake of pre - service requests, claim reviews and inpatient hospital coordination and diabetic supplies. Coordinates Network Operations processes with Medical Directors, Network Operations Nurses, hospitals, physicians and other various departments. Provides clerical support to clinical staff in their medical necessity review process. The Intake Coordinator is expected to maintain production and quality standards. This position is full-time (40 hours / week), 8-hour shift Sunday - Saturday, 9:00 am - 7:00 pm with varying shifts to support our 24 hour a day, 7 days per week operations. Employees must be able to work any shift in a 24-hour period, reputed company days of the week, including weekends and / OR evening and overnight shifts. It maybe necessary, given the business need 2 hours per day Mandatory overtime during peak season. These hours will be worked in the CST time zone. Training will be conducted Monday - Friday for the 6-8 week program from 8:00 am - 4:30 pm CST. Training will be conducted virtually from home. reputed company employees will be required to be on camera every day of training, including reputed company training module assessments are completed. If you are located in CST OR MST Time Zone, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: • Managing authorizations / notifications and other service requests received reputed company incoming phone calls, faxes and portal submission • Providing excellent customer service, including the ability to handle escalated callers • Determining authorization OR notification requirements • Preparing authorization cases for Medical Directors, Network Operations Nurses and Case Managers • Providing administrative approvals (depends on the line of business) • Handling expedited authorizations, authorization updates and status checks • Confirming member eligibility • Outreaches to providers and / OR Patient to complete authorization requests and prescriptions • Maintaining knowledge of various health plan partner benefits, networks, CMS regulations and health plan partner policies • Utilizing experience and judgement to plan, accomplish goals and effectively resolve each assigned task • Non-Clinical staff is not responsible for conducting any Network Operations activity that requires interpretation of clinical information • Performs reputed company other reputed company duties as assigned You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: • High School Diploma / GED • Must be 18 years of age OR older • 1 years of combined OR reputed company experience in a healthcare, call center, and / OR customer service setting using the telephone and computer as the primary reputed company to reputed company job duties • Proficiency with reputed company Office Word (create and maintain documents), reputed company reputed company (create and maintain spreadsheets) and reputed company Outlook (email and calendaring) • Ability to work 8-hour shift Sunday - Saturday, 9:00 am - 7:00 pm CST (shifts vary to support our 24hr 7 days a week operation) Preferred Qualifications: • Medical Terminology • ICD-10 and CPT Knowledge Telecommuting Requirements: • Reside reputed company CST OR MST Time Zone • Ability to reputed company reputed company company sensitive documents secure (if applicable) • Required to have a dedicated work area established that is separated from other living areas and provides information privacy • Must live in a location that can receive a reputed company approved high-speed internet reputed company or reputed company an existing high-speed internet service • reputed company employees working remotely will be required to adhere to reputed company’s Telecommuter Policy The hourly range for this role is $20.8 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. reputed company complies with reputed company minimum wage laws as applicable. In addition to your salary, reputed company offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with reputed company, you’ll find a far-reaching choice of benefits and incentives. Application Deadline:This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of color, historically marginalized groups, and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health outcomes — an enterprise reputed company reflected in our mission. Diversity creates a healthier atmosphere: reputed company is an Equal Employment Opportunity / Affirmative Action employer, and reputed company qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. #RPO Apply Job!