Clinical Assistant needs 1 years experience in a customer service support role is required
Clinical Assistant requires :
- Possible COVID-19 vaccine mandate.
- Customer service support role is required
- Certifications
- Ability to work independently with minimal supervision or function in a team environment sharing responsibility, roles and accountability.
- Proficient interpersonal and organizational skills
- Independent, Sound decision-making and problem-solving skills
- Healthcare environment
- Provider reimbursement methodologies, ICD-9-CM, CPT, HCPCS and UB-92 coding, UHDDS coding guidelines, AHA Coding Clinic
- Must be able to work in an independent and creative manner.
- Self-motivated and able to manage multiple tasks and set priorities.
- Effective time management skills
- Excellent oral and written communication skills
- Strong interpersonal and organizational skills
- Knowledge in Medical terminology
- Various immunizations and / or associated medical tests may be required
- Clinical Assistant duties;
- Supports area clinical team and serves as a proactive resource for members related to disease prevention and benefit education.
- Conduct educational telephone calls advising members of available benefits, services and programs; completes health needs assessment, and refers members to population health management programs as appropriate.
- Reach out to members with identified gaps in care; encouraging and motivating them to become compliant; offering assistance in locating providers and appointment scheduling.
- Manage system work queues; screening identified members for eligibility, prior case activities, recent claims, customer service inquiries and authorization history;
assigning members to clinical team for call outreach and intervention.
- Facilitate research and analysis of inquiries and / or complaints related to processes and designations, member lost incentives, and other program related inquiries
- Work overtime as needed
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