Coordinator, Client Services

1 week ago

Honolulu, Hawaii, United States Evolent Health Full time


Your Future Evolves HereEvolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions.

Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones.

Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done.

We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work.

That's one reason why diversity and inclusion are core to our business.
Join Evolent for the mission. Stay for the culture.

What Youll Be Doing:
TheCoordinator, Client Servicesat Evolent will serve as a point of contact for processing medical treatment requests in accordance with departmental policies, regulatory requirements, and client contractual agreements

Collaboration Opportunities:
The Coordinator, Client Services reports directly to the Manager, Client Services.

In support of our daily operations, this individual also works with our clinical team, which includes our First Level Reviewers and Clinical Reviewers.

Opportunities to work collaboratively with other Client Service Leaders including our Client Service Associate Director and Director may also be available.


What You Will Be Doing:
Reviewing internal workflows and policies to determine if submitted requests are In Scope for review or redirect as required.
Entering data into a proprietary system generates cases for next-level review related to medical treatment requests, referrals, and reconsiderations. These requests may be submitted via fax, email, or provider portal.
Working directly with physicians offices to obtain missing information required to submit a medical request.
Submitting IT tickets to address barriers to generating cases for clinical review and following the ticket through to completion.
Addressing requests promptly and courteously, honoring commitments and displaying persistence in obtaining necessary information to address issues and problems.
Meeting established Client Service Objectives and Key Results.

After demonstrating above-average performance may be uptrained to assist with Health Plan inquiries sent internally to the Client Services team.


Qualifications Required and Preferred:


A high school diploma or GED.(Required)1 3 years of experience in a Coordinator role either requesting or submitting prior authorization requests related tocardiology or oncologyor relevant health care experience in claims or appeals & grievances.

(Required)


Ability to read, write, and speak the English language fluently with patients and providers.(Required)Ability to adapt to fluctuating situations and perform work of a detailed nature, while avoiding errors.(Required)Proficient in using computer and Windows PC applications, which includes strong keyboard and navigation skills.(Required)Team-oriented demonstrates a strong work ethic and commitment to productivity.(Required)Ability to sit for the majority of shifts.(Required)Demonstrated ability to meet established goals while balancing a workload and prioritizing assignments in a remote environment.

(Preferred)Technical Requirements:

We require that all employees have the following technical capability at their home: High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router.

These at-home technical requirements are subject to change with any scheduled re-opening of our office locations.

Evolent is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.

If you need reasonable accommodation to access the information provided on this website, please further assistance.
The expected base salary/wage range for this position is $19-$20/hr. This position is also eligible for a bonus component that would be dependent on pre-defined performance factors.

As part of our total compensation package, Evolent is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees.

All compensation determinations are based on the skills and experience required for the position and commensurate with experience of selected individuals, which may vary above and below the stated amounts.

Don't see the dream job you are looking for? Drop off your contact information and resume and we will reach out to you if we find the perfect fitFor more insights about Evolent Health, click on Life At Evolent ) to learn more#J-18808-Ljbffr

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