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Clinical Support Associate

2 months ago

Santa Barbara, United States Cencal Health Full time

Job Details

Job Location Main Office - Santa Barbara, CA

Position Type Full Time

Education Level Associate's Degree

Travel Percentage None

Job Category Medical Management

Description

California Hourly Range: $22.56 - $31.58 per hour

Job Summary

A Clinical Support Associate Community Supports (CSA-CS) is assigned to the Community Supports Program. The CSA-CS reports to the Community Supports Program Manager or their designee. The CSA-CS is responsible for providing coordination support for the clinical teams, supporting the daily operational functions, facilitating timely work processes, and performing clerical activities of the Community Supports Program. The CSA-CS must have strong and clear written and verbal communication skills. The CSA-CS is responsible for accurate and timely data entry and data collection. The CSA-CS interacts with other CenCal Health employees, providers, and members. CSA-CS may be responsible for processing authorization and referral requests, completing health surveys with members, and following selected members who need periodic telephonic outreach calls.

Duties and Responsibilities

Timely answering of inbound calls in the Health Services' phone queues Make outbound calls to providers, members, and CenCal Health staff regarding operational processes Timely communication of conflicts or difficulties with members or providers to the immediate supervisor Maintain confidentiality and privacy of member information in adherence to HIPAA and Confidentiality laws and regulations Adhere to CenCal Health's mission, protocols, policies, and procedures and meet required performance standards Timely attendance of Company-wide and department meetings and trainings and, as appropriate, actively participate Respond to emails, telephone calls, and other modes of communication promptly, professionally, and courteously Interact with CenCal Health employees, members, and providers professionally Responsible for supporting the daily operational functions, facilitating timely work processes, and performing clerical activities associated with Community Supports Work closely with Case Management, the Community Supports team, and internal CenCal Departments related to Community Supports activities Managing the call queue, including supporting members, Community Support providers, and providers related to Community Support referrals and provider reassignment process. Responsible for the Community Support referral intake process. Conduct follow-up calls to members and providers to ensure timely access to Community Support services. Organize, schedule, track, and monitor member contacts Assist with mailings associated with Community Support (Member assignment and Auth approval notifications) Assist with mailings of Community Support NOA's as requested Assist the Community Support Program Manager with data tracking as requested Other duties as assigned

Qualifications

Knowledge/Skills/Abilities

Required: Ability to work independently and follow directions with minimal supervision and as an active participant of an interdisciplinary team Ability to utilize constructive feedback as a learning and growth opportunity Demonstrate excellent organizational and multi-tasking skills Understand basic medical terminology, billing (CPT), and diagnoses (ICD-10) coding Maintain member confidentiality and HIPAA compliance Must be detail-oriented and maintain clear and accurate records Complete assigned duties while adhering to regulatory timelines Must be able to type at a minimum of 35 wpm Work effectively with people with varying backgrounds and educational levels Prepare grammatically correct, clear, and concise correspondence

Preferred: Basic knowledge of Medi-Cal and its covered services Knowledge of health-related community-based organizations, health care delivery systems, and resources for the low-income and elderly population As designated, bilingual in Spanish

Education and Experience

Required: High school diploma or GED Twelve (12) months of full-time, or its equivalent, experience in a medical office, health plan, managed care organization, hospital (ED or inpatient), skilled nursing facility, clinic, or other healthcare setting working directly with patients, members, providers and/or other clinicians Successful completion of one of the following accredited education programs: Medical Assistant or Medical Office Professional. Successful completion can substitute for six (6) months of work experience

Preferred: Associate degree in business, health science, healthcare, health management, or related field OR three (3) years of experience as a Certified Medical Assistant, Certified Nursing Assistant, or Licensed Vocational/Practical Nurse may substitute for an Associate Degree Two (2) years of full-time, or its equivalent, of clinical experience in an outpatient or ED clinic, health plan, managed care, or medical office setting.

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