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Clinical Support Coordinator
Clinical Support CoordinatorAmerit Consulting • Bakersfield, CA, US
Clinical Support Coordinator

Clinical Support Coordinator

Amerit Consulting • Bakersfield, CA, US
16 hours ago
Job type
  • Full-time
Job description

OVERVIEW :

Our client, a provider of Health, Dental, Vision, Medicaid and Medicare Healthcare service plans in the state of California with 4.7 million members and $22.9 billion of annual revenues , seeks an accomplished Clinical Support Coordinator.

IMPORTANT NOTES :

  • This will be a remote job.
  • Duration : 3+ Months (with potential to extend or convert to FTE)
  • Working Hours : 8 : 00 AM – 4 : 30 PM PST (40 hours / week)
  • Candidate MUST have high-speed wired Internet connection. Wi-Fi / Wireless connections are not allowed.
  • Candidate MUST have a reliable home-office environment.

Responsibilities :

  • Utilize assigned systems and processes to receive new quality-of-care cases.
  • Work with clinical reviewers to prepare letters and request medical records.
  • Document all attempts to obtain required information and provide updates to clinical reviewers.
  • Monitor incoming emails and faxes for receipt of requested information.
  • Ensure cases progress through required process steps within defined timeframes.
  • Request medical records and responses from providers via fax, secure email, or remote EMR systems.
  • Validate and update provider contact information in departmental repositories.
  • Follow up with providers by phone or email regarding outstanding records or responses.
  • Review incoming medical records for completeness before forwarding for clinical review.
  • Re-contact providers if documentation is incomplete.
  • Consult with CQR Lead / RN on complex cases or status concerns.
  • Prioritize tasks to meet turnaround time expectations.
  • Research provider and member information using internal applications (e.g., claims, PCP details, plan type).
  • Enter accurate data into department databases for reporting and tracking purposes.
  • Actively contribute to team collaboration and help foster a positive work environment.
  • Provide feedback for continuous process improvement initiatives.
  • Work with limited to moderate supervision for routine tasks.
  • Required Qualifications :

  • Minimum High School Diploma.
  • Candidate must have 3-5 years of prior authorizations background handling medical claims within health insurance industry.
  • Strong administrative skills with high attention to detail and time management.
  • Ability to work effectively in a fully remote environment.
  • Proficiency in Microsoft Word and Excel.
  • Experience with Vivaldi or other clinical documentation system s.
  • Strong business writing skills.
  • Prior experience with health plans, IPAs, or healthcare operations.
  • I'd love to talk to you if you think this position is right up your alley, and assure prompt communication, whichever direction. If you're looking for rewarding employment and a company that puts its employees first, we'd like to work with you.

    Recruiter Name : Jatin Rattan

    Title : Senior Recruiter

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    Clinical Coordinator • Bakersfield, CA, US

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