Job Description
Clinical Administrative Coordinator
Remote PST
Equity Staffing is searching for a Remote Clinical Administrative Coordinator. This position is with a Fortune 500 organization. Our client serves more than 85 million people and has a reputation for bold ideas. If you enjoy working with energetic people in a collaborative environment, we want to speak with you!
Position is 100% Remote/WFH Opportunity***
Specific Duties:
- Responsible for initial triage of members, administrative intake of members or managing the admission/discharge information post-notification, working with hospitals and the clinical team.
- Includes managing incoming calls, Receive calls requesting medical/behavioral/clinical services or benefits information (e.g., from providers or members)
- Managing requests for services from providers/members
- Providing information on available network services and transferring members as appropriate to clinical staff.
- Manages the referrals process, processes incoming and outgoing referrals, and prior authorizations.
- Help in supporting a government Service Contract Act (SCA) agreement.
- Serve as primary point of contact for providers or members regarding medical/behavioral/clinical services or benefits
- Extract and review fax requests for medical or clinical services
- Receive electronic referral form requests for medical/behavioral/clinical services
- Ask callers standard questions to understand requests, gather necessary information, and assess urgency
- Access electronic member files using policy or id number
- Determine member eligibility
- Follow protocols to task requests appropriately
- Check procedure codes against notification requirements and benefit coverage to determine next steps
- Reference automated job aid tools via the computer to identify appropriate procedures when needed
- Schedule appointments for members based on request
Must have qualifications/experience:
- High school education or equivalent experience.
- May act as a resource for others.
- Medical Office Experience
- Medical terminology Knowledge
- Experience working in a fast paced team environment
- Great Multitasker
- Positive Attitude
- Good Typing Skills
- Great Customer Service Skills
- Attention to Detail
- Strong Organizational Skills
- Effective communication skills both written and verbal
- Strong computer skills
- Proficient in Microsoft Office Suite of Tools.
- Critical thinking skills.
- Ability to work with others