Job Abstract

Your Role

The Medical Care Solutions Clinical Service Intake team responsible for timely and accurate processing of Treatment Authorization Request. The Clinical Services Coordinator will report to the Supervisor of Clinical Services Intake. In this role you will be for supporting clinical staff day to day operations for Promise lines of business.

Your Work

In this role, you will:

• Process Faxed /Web Portal /Phoned in Authorizations Request, UM/CM requests and/or calls left on voicemail
• Select support for Case Manager such as mailings, surveys
• Data entry including authorization forms, high risk member information, verbal HIPPA authorizations information for case creation.
• Support to Advanced/Specialist CSC
• Assign initial EOA days, or triage to nurses, based on established workflow
• Research member eligibility/benefits and provider networks
• Serves as initial point of contact for providers and members in the medical management process by telephone or correspondence.
• Assists with system letters, requests for information and data entry
• Provides administrative/clerical support to medical management
• Intake (received via fax, phone, or portal). Data entry including authorization forms, high risk member information, verbal HIPPA authorizations information for case creation
• Provide workflow guidance to offshore representatives
• Other duties as assigned