Current jobs related to Clinical Services Coordinator, Intermediate - Rancho Cordova - Blue Shield of California

  • Clinical Services Coordinator, Intermediate

    6 days ago

    Rancho Cordova, United States Blue Shield of California Full time

    Your Role The MCS Clinical Service Intake team responsible for timely and accurate processing of Treatment Authorization Requests. The Clinical Services Coordinator (CSC), Intermediate will report to the Supervisor of Clinical Services Intake. In this role you will be for supporting clinical staff day to day operations for Promise (Medi-Cal) or...

  • Clinical Services Coordinator, Intermediate

    6 days ago

    Rancho Cordova, United States Blue Shield of California Full time

    Your RoleThe MCS Clinical Service Intake team responsible for timely and accurate processing of Treatment Authorization Requests. The Clinical Services Coordinator (CSC), Intermediate will report to the Supervisor of Clinical Services Intake. In this role you will be for supporting clinical staff day to day operations for Promise (Medi-Cal) or...

  • Clinical Services Coordinator, Intermediate

    6 days ago

    Rancho Cordova, United States Blue Shield of California Full time

    Your Role The MCS Clinical Service Intake team responsible for timely and accurate processing of Treatment Authorization Requests. The Clinical Services Coordinator (CSC), Intermediate will report to the Supervisor of Clinical Services Intake. In this role you will be for supporting clinical staff day to day operations for Promise (Medi-Cal) or...

  • Clinical Services Coordinator, Intermediate

    5 days ago

    Rancho Cordova, United States Blue Shield of California Full time

    Your Role The MCS Clinical Service Intake team responsible for timely and accurate processing of Treatment Authorization Requests. The Clinical Services Coordinator (CSC), Intermediate will report to the Supervisor of Clinical Services Intake. In this role you will be for supporting clinical staff day to day operations for Promise (Medi-Cal) or...

  • Clinical Services Coordinator, Intermediate

    2 months ago

    Rancho Cordova, United States Blue Shield of California Full time

    Your Role The Specialty Services team is a branch off the MCS Intake team. The Clinical Support Coordinator will report to the Specialty Services Manager. In this role you will be required to process phone and faxed requests for Continuity of Care, Access to Care for both commercial and Medi-Cal membership. This role may also require Peer or Peer provider...

  • Clinical Services Coordinator, Intermediate

    1 month ago

    Rancho Cordova, United States Blue Shield of California Full time

    Your RoleThe Specialty Services team is a branch off the MCS Intake team. The Clinical Support Coordinator will report to the Specialty Services Manager. In this role you will be required to process phone and faxed requests for Continuity of Care, Access to Care for both commercial and Medi-Cal membership. This role may also require Peer or Peer provider...

  • Clinical Services Coordinator, Intermediate

    1 month ago

    Rancho Cordova, United States Blue Shield of California Full time

    Your Role The Specialty Services team is a branch off the MCS Intake team. The Clinical Support Coordinator will report to the Specialty Services Manager. In this role you will be required to process phone and faxed requests for Continuity of Care, Access to Care for both commercial and Medi-Cal membership. This role may also require Peer or Peer provider...

  • Clinical Services Coordinator, Intermediate

    2 months ago

    Rancho Cordova, United States Blue Shield of California Full time

    Your Role The Specialty Services team is a branch off the MCS Intake team. The Clinical Support Coordinator will report to the Specialty Services Manager. In this role you will be required to process phone and faxed requests for Continuity of Care, Access to Care for both commercial and Medi-Cal membership. This role may also require Peer or Peer provider...

  • Clinical Services Coordinator, Intermediate

    1 month ago

    Rancho Cordova, United States Blue Shield of California Full time

    Your Role The Specialty Services team is a branch off the MCS Intake team. The Clinical Support Coordinator will report to the Specialty Services Manager. In this role you will be required to process phone and faxed requests for Continuity of Care, Access to Care for both commercial and Medi-Cal membership. This role may also require Peer or Peer provider...

  • Clinical Services Coordinator, Intermediate

    2 months ago

    Rancho Cordova, United States Blue Shield of California Full time

    Your Role The Specialty Services team is a branch off the MCS Intake team. The Clinical Support Coordinator will report to the Specialty Services Manager. In this role you will be required to process phone and faxed requests for Continuity of Care, Access to Care for both commercial and Medi-Cal membership. This role may also require Peer or Peer provider...

  • Clinical Services Coordinator, Intermediate

    5 days ago

    Rancho Cordova, CA, United States Blue Shield of California Full time

    Your Role The MCS Clinical Service Intake team responsible for timely and accurate processing of Treatment Authorization Requests. The Clinical Services Coordinator (CSC), Intermediate will report to the Supervisor of Clinical Services Intake. In this role you will be for supporting clinical staff day to day operations for Promise (Medi-Cal) or...

  • Clinical Services Coordinator, Intermediate

    5 days ago

    Rancho Cordova, CA, United States Blue Shield of California Full time

    Your Role The MCS Clinical Service Intake team responsible for timely and accurate processing of Treatment Authorization Requests. The Clinical Services Coordinator (CSC), Intermediate will report to the Supervisor of Clinical Services Intake. In this role you will be for supporting clinical staff day to day operations for Promise (Medi-Cal) or...

  • Clinical Services Coordinator, Intermediate

    2 months ago

    Rancho Cordova, CA, United States Blue Shield of California Full time

    Your Role The Specialty Services team is a branch off the MCS Intake team. The Clinical Support Coordinator will report to the Specialty Services Manager. In this role you will be required to process phone and faxed requests for Continuity of Care, Access to Care for both commercial and Medi-Cal membership. This role may also require Peer or Peer provider...

  • Service Coordinator

    3 weeks ago

    Rancho Cordova, United States Johnson Controls Full time

    Johnson Controls - 3140 Gold Camp Dr [Dispatcher Coordinator] As a Service Coordinator at Johnson Controls, you'll: Be responsible for the scheduling and optimization of service work; Utilize the automated scheduler functionality in Oracle (ACE) and assign the service call to the optimal technician; Communicate and resolve issues with customers and personnel...

  • Pharmacy Services Coordinator

    4 weeks ago

    Rancho Cordova, California, United States Aditi Consulting Full time

    Job Summary: Aditi Consulting is seeking a skilled Pharmacy Services professional to join our team. As a Pharmacy Services Coordinator, you will play a critical role in providing efficient and accurate responses to external customers and internal team members. Your main function will be to resolve outpatient pharmacy benefit coverage issues, communicate drug...

  • Senior Social Services Coordinator

    4 weeks ago

    Rancho Cordova, California, United States Blue Shield of CA Full time

    About the RoleThe Senior Social Services Coordinator will provide outreach to Blue Shield of California Promise Health Plan members and conduct assessments for social drivers of health needs. This role requires experience working with the Medi-Cal population and knowledge of community resources and related interventions.Key ResponsibilitiesComplete member...

  • Service Coordinator

    4 weeks ago

    Rancho Cordova, California, United States Johnson Controls Full time

    Job SummaryThe Service Coordinator will support the fire domain service business in coordination with the other service support team members. This role is responsible for ensuring the smooth operation of the sprinkler service department.Key ResponsibilitiesRun a weekly Open Call Report for the sprinkler department.Bill completed service SRs for local...

  • Service Coordinator

    2 months ago

    Rancho Cordova, United States Johnson Controls Full time

    Be part of the future! We are one team, dedicated to working collaboratively to create the purposeful solutions that propel the world forward. We hope you will join our diverse team of top people - you bring your talent, and we'll give you the space and opportunities to grow and succeed. We are committed to make a difference. What we offer: Competitive...

  • Clinical Nurse

    1 month ago

    Rio Rancho, United States TotalMed Staffing Full time

    We are looking for a Clinical Nurse to join our Intermediate Care Unit team in Rio Rancho, New Mexico. In this role, you will be responsible for providing high-quality care to patients who are transitioning from intensive care to general care. The ideal candidate will have a strong clinical background and be able to work effectively in a fast-paced...

  • Nursing, Pharmacy,

    2 months ago

    Rancho Cordova, United States Talent Software Services Full time

    Job Description: Summary: The main function of Pharmacy Services is to provide efficient and accurate responses to external customers (physicians, office staff, pharmacy providers, members and brokers) and internal team members. Resolves outpatient pharmacy benefit coverage (inclusion/exclusion), prescription claim problems, communicates drug formulary...

Clinical Services Coordinator, Intermediate

1 month ago

Rancho Cordova, United States Blue Shield of California Full time

Your Role

The Medical Care Solutions Federal Employee Program team provides Prior Authorization and Utilization Management services to our members. The Clinical Support Coordinator will report to the Non-Clinical Operations Manager. In this role you will be responsible for a combination of answering a high-volume of inquiry calls, receiving and processing admits from hospitals when members are admitted to a facility, receiving and loading Prior Authorization requests into in-house computer software, and other duties as assigned.



Your Work

In this role, you will:

  • Answer a high volume of phone inquiries and load faxed authorizations
  • Data entry including prior authorization forms, high risk member information, verbal HIPPA authorizations information for case creation
  • Support to Advanced/Specialist CSCs
  • Assign initial EOA days, or triage to nurses, based on established workflow 
  • Select support for Case Manager such as mailings, surveys
  • Research member eligibility/benefits and provider networks 
  • Verify member eligibility
  • Process hospital admits
  • Send referrals to Case Management as appropriate
  • Other duties as assigned

Your Knowledge and Experience

  • Requires a high school diploma or equivalent
  • Requires at least 3 years of prior relevant experience
  • Prefers strong attendance record
  • Prefers solid technical skills – ability to navigate MS programs and learn in-house software
  • Prefers sharp communication and teamwork skills
  • Preferred – experience within FEP using AuthAccel and FEP Direct
  • Preferred – experience with medical coding - CPT/Dx

 

Salary Range 

The pay range for this role is: $ 20.47 to $ 28.66 for California.

 

Note

Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.