Posted in Other 30+ days ago.
Type: Full Time
Clinical Support Coordinator - Temporary
Job ID
2020-3425
Category
Administrative/Office Support
Type
Consultant
Actual Work Location
101 Wason, Springfield, MA
Why This Role is Important to Us
At Commonwealth Care Alliance (CCA), our vision is to lead the way in transforming the nation's healthcare for individuals with the most significant needs. If being part of a team and working on combined solutions for patients matters to you…keep reading. We may have something to talk about.
This position includes a variety of clinical support functions for clinical staff, clinical managers and clinical directors who care for CCA's Senior Care Options (SCO) and One Care (ICO) members across the state. These functions are related to the overall workflows of CCA's clinical staff, in addition to managing a variety of internal and external communication requests as directed. This role also entails interaction with members, mostly over the phone. The position provides administrative support for both clinical and non-clinical office-based staff as needed.
This is a Monday through Friday position and there are two schedules:
8:30am - 5pm and 10:30am - 7pm.
At CCA, your role matters. You'll be joining an organization that is mission driven, believes in internal mobility, has excellent benefits (see below) and embraces innovation when it comes to serving our patients.
What You'll Be Doing
The assignments performed by a Clinical Support Coordinator are structured in the main support functions listed below:
Triaging
- Triage phone calls from members, vendors, agencies, and staff - including urgent communications
- Triage documents: scanning, faxing, sorting, and assigning documents to staff, or department work queue to be followed up in the appropriate Electronic Medical Record (such as eClinicalWorks, EPIC, CIS, Athena, etc.) and/or Care Management Platform (Guiding Care) - including urgent communications
- Triage and distribute tasks to interdepartmental workgroups/staff within the appropriate Electronic Medical Record and/or Care Management Platform per guidelines established by leadership
Authorizations
- Provide accurate, prompt, and appropriate entry of medical referrals and requests from CCA clinicians, members, vendors, and/or providers for services needing prior authorizations
- Ensure submission of information needed for completion of service decision requests based as validated and instructed by clinical staff
- Provide clear and accurate documentation of all communication and activities
- Handle all requests timely and accurately, adhering to performance and compliance measures
Fulfillment
- Place orders with vendors based on clinical staff and/or member requests for supplies, equipment, and/or services
- Coordinate procurement of support services in the community authorized by clinical staff
- Follow-up on order accuracy, timeliness, and delivery/shipment of goods and services, as well as member outreach to confirm the appropriateness of the order and/or service provided
- Manage exceptions and substitutions. Work to resolve problems
- Ensure closed loop communication processes
- Data Integrity
- Update and maintain data in multiple Electronic Medical Records (internal and external), Care Management Platform (Guiding Care), and Enrollment Platform (Market Prominence) with accurate information regarding clinical care team, support service agency assignment, and member demographics
- Reconcile data displayed in multiple Electronic Medical Records (internal and external) and Care Management Platform to ensure accurate data on reporting for managerial, operational, and financial purposes
Scheduling
- Schedule home visits for clinicians such as Annual Comprehensive Assessments (ACA), SCO Personal Care Attendant (PCA) Evaluations, Minimum Data Set Assessments (MDS), Pharmacy Medication Management visit.
- Document scheduling attempts
- Place reminder calls for scheduled visits
Additional duties as requested by supervisor.
What We're Looking For
Required Qualifications
Associate degree or at least 2+ years of applicable experience
- 2+ years office/administration experience
- Basic arithmetic skills
- Proficiency in Microsoft Office Suite
Preferred Qualifications
- Bachelor's degree
- Experience working in a health plan, medical group, health-related facility or medical/DME supplier
Education, training or experience as an insurance coordinator or medical coder/biller
- Knowledge of medical terminology
Working knowledge of CPT and ICD coding
- Experience with Electronic Medical Records and/ or Care Management Platform
Bilingual
Does this sound like you? If you're interested in this opportunity, please apply today. The process takes 10-15 minutes.
keywords: administrative, clerical, office, clinical, medical, healthcare, schedule, coding, CPT, ICD, billier, authorization, triage, temporary, consultant, Sprinfield, MA, Massachusetts
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Commonwealth Care Alliance is an equal opportunity employer. Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information or any other category protected by applicable federal, state or local laws.
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