Clinical Assistant needs 1 years experiencein a customer service support role isrequired
Clinical Assistantrequires :
Possible COVID19 vaccinemandate.
Customer service support role isrequired
Certifications
Ability to work independently with minimal supervision or functionin a team environment sharing responsibility roles andaccountability.
Proficient interpersonal andorganizational skills
Independent Sounddecisionmaking and problemsolving skills
Healthcare environment
Provider reimbursementmethodologies ICD9CM CPT HCPCS and UB92 coding UHDDS codingguidelines AHA Coding Clinic
Must be able towork in an independent and creative manner.
Selfmotivated and able to manage multiple tasks and setpriorities.
Effective time managementskills
Excellent oral and written communicationskills
Strong interpersonal and organizationalskills
Knowledge in Medicalterminology
Various immunizations and / orassociated medical tests may be required
ClinicalAssistant duties;
Supports area clinical teamand serves as a proactive resource for members related to diseaseprevention and benefit education.
Conducteducational telephone calls advising members of available benefitsservices and programs; completes health needs assessment and refersmembers to population health management programs asappropriate.
Reach out to members withidentified gaps in care; encouraging and motivating them to becomecompliant; offering assistance in locating providers andappointment scheduling.
Manage system workqueues; screening identified members for eligibility prior caseactivities recent claims customer service inquiries andauthorization history;
assigning members to clinical team for calloutreach and intervention.
Facilitate researchand analysis of inquiries and / or complaints related to processesand designations member lost incentives and other program relatedinquiries
Work overtime asneeded
Remote Work :
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