Clinical Assistant

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